essay about alcohol and drugs

Drug and Alcohol Abuse Analytical Essay

Introduction, works cited.

For along time now, drug and alcohol abuse in the society has been a problem that affects the youth and the society at large. The youth in the society get engaged in abusing substances that they feel all help them forget their problems. This paper highlights the problems of drug abuse and alcohol drinking among the youth in the society.

Alcohol is a substance that contains some elements that are bring about physical and psychological changes to an individual. Being a depressant, alcohol affects the nervous system altering the emotions and perceptions of individuals. Many teenager abuse alcohol and other drug substances due to curiosity, the need to feel good and to fit in their different groups. Drinking alcohol should not be encouraged because it usually affects the health of the youth.

It puts their health at a risk. Drinking youth are more likely to engage in irresponsible sexual activities that may result in unexpected pregnancies and sexually transmitted diseases. Additionally, teenagers who drink are more likely to get fat while complicating further their health conditions. Moreover, the youth drinking are at a risk of engaging in criminal activities hence being arrested (Cartwright 133).

According to the Australian Psychological Society, a drug can be a substance that brings about physical or psychological changes to an individual (2). Youngsters in the in the community take stuffs to increase enjoyment or decrease the sensational or physical pain. Some of the abused drugs by the youth in the society include marijuana, alcohol, heroine and cocaine.

The dangers of drug abuse are the chronic intoxication of the youth that is detrimental to their societies. Much intake of drugs leads to addiction that is indicated by the desire to take the drugs that cannot be resisted.

The effect of alcohol and other hard drugs are direct on the central nervous system. Alcohol and drug abuse is linked to societal practices like, partying, societal events, entertainment, and spirituality. The Australian Psychological Society argues that the choice of a substance is influenced by the particular needs of the substance user (3).

However, the effects of drug abuse differ from one individual to another. The abuse of drugs becomes a social problem whenever the users fail to meet some social responsibilities at home, work, or school. This is usually the effect when the substances are used more than they are normally taken. Additionally, when the use of substances is addictive, it leads to social problems (Cartwright 135).

Drug and alcohol abuse among the youth in the society should be discouraged and voided at all costs. The youth are affected and the society is affected. The productive young men and women cannot perform their social duties. One way in which the abuse of drugs and alcohol can be avoided in the society is through engaging the youth in various productive activities. This will reduce their idle time while keeping them busy (Cartwright 134).

They will not have enough time for drinking. Additionally, they will have fewer problems to worry about. They should also be educated and warned about the dangers of drug and alcohol abuse both to their health and to the society. Since alcohol and substance abuse is related to increased crime in the society, its reduction will lead to reduced crime rates and economic growth.

The Australian Psychological Society. Alcohol, and Other Drugs . Australian Psychological society. Web.

Cartwright, William. Costs of Drug Abuse to the Society. The Journal of Mental Health Policy and Economics , 1999. 2, 133-134.

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Bibliography

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Essay on Drugs And Alcohol

Students are often asked to write an essay on Drugs And Alcohol in their schools and colleges. And if you’re also looking for the same, we have created 100-word, 250-word, and 500-word essays on the topic.

Let’s take a look…

100 Words Essay on Drugs And Alcohol

Introduction.

Drugs and alcohol are substances that can change how your body and mind work. Drugs can be medicines or illegal substances. Alcohol is a type of drug that people often drink in social settings.

Effects on the Body

Drugs and alcohol can harm your body. They can damage your organs, like your liver and brain. They can also make you feel sick, tired, or confused. Some drugs can even make you see or hear things that aren’t real.

Effects on the Mind

Drugs and alcohol can also affect your mind. They can change your mood and make you feel happy, sad, angry, or scared for no reason. They can also make it hard for you to think clearly.

Sometimes, people can become addicted to drugs or alcohol. This means they feel a strong need to keep using these substances, even if they know it’s bad for them. Addiction can lead to serious health problems.

In conclusion, drugs and alcohol can harm your body and mind, and lead to addiction. It’s important to make healthy choices and avoid these substances.

250 Words Essay on Drugs And Alcohol

Drugs and alcohol are substances that can change how your body and mind work. They can hurt you and lead to problems at home, school, and with friends.

What Are Drugs and Alcohol?

Drugs are chemicals that change the way your body works. Some are legal, like medicines prescribed by doctors or sold in stores. Others are illegal. Alcohol is a kind of drug that is legal for adults to use, but it can still be harmful.

Effects on Health

Drugs and alcohol can hurt your health. They can damage your brain, heart, and other important organs. If you use them a lot, you might not be able to think clearly or make good choices. Drugs and alcohol can also make it hard for you to control your actions.

Effects on Life

Using drugs and alcohol can cause problems at school and home. You might get bad grades, lose friends, or have fights with your family. Also, it’s illegal for kids and teens to buy alcohol or use illegal drugs. If you’re caught, you could get in trouble with the law.

Remember, it’s important to make smart choices about drugs and alcohol. If you’re feeling pressured to try them, talk to someone you trust. There are always better ways to handle stress, have fun, and fit in.

500 Words Essay on Drugs And Alcohol

What are drugs and alcohol.

Drugs and alcohol are substances that can change how your body and mind work. Drugs can be legal, like medicine prescribed by doctors, or illegal. Alcohol is a legal drug that adults can buy, but it’s not legal for kids and teens. Both can be very harmful if misused.

Effects of Drugs and Alcohol

Drugs and alcohol can have a big impact on the body and mind. They can make you feel happy, relaxed, or excited for a short time. But they can also make you feel sick, confused, or scared. Over time, using drugs and alcohol can lead to serious health problems. These can include heart disease, liver damage, and problems with the brain.

Drugs, Alcohol and Society

Drugs and alcohol can cause problems in society too. People who use drugs or drink too much alcohol might not do well at school or work. They might get into fights or cause accidents. They can even end up in jail. And it’s not just the people who use drugs or alcohol who are affected. Their families, friends, and communities can be hurt too.

Why Do People Use Drugs and Alcohol?

There are many reasons why people might start using drugs or alcohol. Some might do it to fit in with friends or to feel better when they’re sad or stressed. Others might be curious or just want to try something new. But no matter why they start, it can be very hard to stop. That’s because drugs and alcohol can be very addictive. This means that the more you use them, the more your body needs them.

Helping People with Drug and Alcohol Problems

If someone has a problem with drugs or alcohol, it’s important they get help. There are many people and organizations that can help, like doctors, therapists, and support groups. They can provide treatment to help people stop using drugs or alcohol, and support to help them stay sober.

In conclusion, drugs and alcohol can cause a lot of harm. They can hurt your body and mind, cause problems in society, and be very hard to quit. But there is help available for people who need it. And by learning about the dangers of drugs and alcohol, we can make better choices for ourselves and our communities.

That’s it! I hope the essay helped you.

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Drug and Alcohol Addiction, Essay Example

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There is a growing population of individuals who are affected by drug and alcohol addiction. The need for one more fix or one more drink consumes them until it is no longer a personal choice. There are many theories as to the cause and effects of this. Understanding the severity of this addiction requires a closer look at the dependency. Alcohol and drug abuse is a growing issue that negatively affects the nervous system, sensory input, and behavior of individuals.

It is important to consider the causes associated with this condition. Essentially heredity is a contributing factor in drug and alcohol addiction. This is directly associated with the environmental contribution to this dependency as well. “So when considering the impact our psychological makeup plays in drug addiction and alcoholism – our psychological makeup is largely formed in our formative childhood years – mostly from our family environment, particularly our parents.” (Peter 1) Ones environment walks hand-in-hand with personal heredity. For example, a person who grows in a house with a father who drinks excessively every day can blame their alcoholism on both environment and heredity.

The brain and nervous system are both affected by addiction. Different drugs have different effects on the brain. “Drugs are chemicals. They work in the brain by tapping into the brain’s communication system and interfering with the way nerve cells normally send, receive, and process information. “(Drugs, Brain, and Behavior 1) There are three main effects those drugs have on the central nervous system. That is a depressant, stimulant, and hallucinogens. Depressants are the type of drugs that slow down the functions of the central nervous system. This drug affects the concentration and coordination part of the central nervous system. Stimulants take action on the central nervous system to speed up the messages to and from the brain. This drug affects the aggression and paranoia part of the nervous system. Hallucinogens are drugs that affect perception. The part of the nervous system that this drug impairs is the emotional and psychological feelings.

Sensory input can be altered by drug and alcohol addiction. It can control the internal sensory like the heart rate and body temperate. Both drugs and alcohol can cause and increase or decrease to these. External sensory are sight, sound, taste, smell, touch, and balance. The external sensory inputs are affected just as much as the internal. Often when impaired, balance is not at its best point. Touch, smell, and sound are distorted. The sensory input is directly affected by drug and alcohol use.

There are typical symptoms associated with drug and alcohol addiction. According to HelpGuide.org one needs to watch out for the following:

You’ve built up a drug tolerance.
You take drugs to avoid or relieve withdrawal symptoms.
You’ve lost control over your drug use.
Your life revolves around drug use.
You’ve abandoned activities you used to enjoy
You continue to use drugs, despite knowing it’s hurting you. (Drug Abuse and Addiction)

Recognizing these symptoms is an important part of understanding the addiction. There are other symptoms that could surface, depending on the type and severity of the addiction, but these are the typical signs to be aware of.

Drug and alcohol addiction can have a very negative impact on the user’s relationships. The individual who is using often neglect responsibilities, this includes people and obligations. It can lead to unnecessary fighting and animosity between partners, friends, coworkers, and even bosses. The loss of rational thought processing creates an environment for trouble. Funding a personal habit can be quite expensive as well, which could cost a financial strain on relationships as well. There is also a higher concern with drugs or alcohol than building relationships of any type.

Group behavior can be affected by drug and alcohol addiction as well. In a negative way, it can lead others down the negative dependency path as well. It’s almost like follow the leader, a member of the group needs a fix and the others do as well. On the positive side, typically rehabilitation with drug and alcohol addiction takes place in group as well. The members listen to the troubles that individuals are having and offer a supporting atmosphere. Group behavior can be both good and bad depending on which side of the addiction it is.

Treatment for drug and alcohol addiction can vary depending on the person and the severity of the disease. According to the National Institute on Drug Abuse, “Medication and behavioral therapy, especially when combined, are important elements of an overall therapeutic process that often begins with detoxification, followed by treatment and relapse prevention. Easing withdrawal symptoms can be important in the initiation of treatment; preventing relapse is necessary for maintaining its effects.” (Drug Facts) Having a change in environment and a strong support group is important for the treatment to be successful as well.

Alcohol and drug abuse is a growing issue that negatively affects the nervous system, sensory input, and behavior of individuals. This addition can be directly attributed to heredity and environmental factors. Drugs and alcohol can have a negative effect on the brain and the nervous system. Knowing the symptoms of this addiction will make it easier to determine if there is really a problem. There is treatment available for drug and alcohol addiction. Understanding the problem is a big part of reaching a solution.

Works Cited:

Peter, Carl. “Drug Addiction and Alcoholism Causes: The Hereditary and Genetic Influence”. Health Journal Online . 2010. Web. 2 Nov. 2012.

“Drugs, Brains, and Behavior: The Science of Addiction”. National Institute on Drug Abuse. 2010. Web. 2 Nov. 2012.

“Drug Abuse and Addiction”. HelpGuide.org . Web. 2 Nov. 2012.

“Drug Facts: Treatment Approaches for Drug Addiction”. National Institute on Drug Abuse. 2010. Web. 2 Nov. 2012

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Drugs And Alcohol Essays

Drugs And Alcohol Essays (Examples)

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Drugs and alcohol effects on college.

Drugs and Alcohol Effects on College / Campuses Current Literature On Drugs And Alcohol On College Campuses Drugs and Alcohol Effects on College Campuses The number of college students using the drug and alcohol in the United States of America has been on the increase. Binge drinking is the way most students in these colleges take alcohol. College students are a visible group where alcohol and drug abuse have become a common place. Effects of alcohol on college students cause social, legal, and academic problems. Students, on the other hand, engage in risky sex behaviors and other physical activities that might even result to death. Studies indicate that approximately four out of five college students in the United States abuse alcohol. About 1700 college students aged an estimate between 18-24-year die unintentionally because of alcohol and drug abuse. Most of these deaths are a result of motor vehicle accidents or injuries from assault….

Mohler-Kuo, M., Dowdall, G.W., Wechsler, H., & Koss, M. P (2004). Correlation of rape while intoxicated a national sample of college women. Journal of Studies on Alcohol and Drugs,

Marshall, B.L., Roberts, K.J., Donnelly, J.W., & Rutledge, I.N. (2011). College Student

Perceptions

Drugs and Alcohol Issues Many Americans Have

Drugs and Alcohol Issues Many Americans have trouble getting to sleep. As a results they may turn to sleeping pills to help them get some ZZZs. How do you feel about the prescribing of sleeping pills for people to assist them with sleeping? Should our medical industry instead be writing prescriptions for vigorous activity which would also help people sleep better? How about a prescription for caffeine avoidance? There is nothing wrong with physicians recommending non-pharmaceutical alternatives to insomnia or any other medical or health problem. However, the autonomous rights of patient make it inappropriate for the physician to substitute his or her values for those of the patient. The physician's duty is to disclose all relevant information and to provide good-faith advice; but the ultimate choice of modality to address a given problem must always remain with the patient. On some level, the same criticism of using sleeping pills could be leveled….

Drugs and Alcohol

Drug Treatment and Prevention Program: The Local Alcoholics Anonymous Chapter The primary function of the program: The primary function of Alcoholics Anonymous is to private group counseling as a resource to alcoholics and recovering alcoholics. Often paired with community centers and local places of worship, the A.A. chapter in my community uses a nearby Protestant Church. According to the volunteer counselor whom I interviewed for this program profile, the local chapter has a rotating membership of roughly 70 nearby residents. The counselor indicates this they serve the program's primary function by organizing and moderating group meetings. The clients served: serves alcoholics and recovering alcoholics in 114,000 communities worldwide. The A.A. assesses its membership at roughly 2,000,000 members from a total of 170 countries. This makes it the largest and most widely utilized treatment organizations for addressing the disease of alcoholism. The clients served in the local community, the counselor tells, come from all walks….

Works Cited:

Alcoholics Anonymous (AA). (2012). A.A. At a Glance. AA.org.

Arkowitz, H. & Lillenfeld, S. (2011). Does Alcoholics Anonymous Work? Scientific American.

Kurtz, E. (2002). Alcoholics Anonymous and the Disease Concept of Alcoholism. Silkworth.net.

Adolescent Drugs and Alcohol Abuse

[Shope, Jean T, 2004] Cost of Addictive ehavior (individual and family implications) Asides the fact that drugs and alcohol rehabilitation add billions of dollars to the nations health care costs, the addictive nature of these substances also implies direct costs to the families concerned. Adolescents have to spend hundreds of dollars for buying drinks and drugs and peer pressure would encourage them to engage in culpable actions. Typically, an alcoholic or drug-abusing adolescent would meet his financial needs by stealing from his own house. The next step is lying and borrowing from friends and in the worst case submitting to demands for sexual favors in order to sustain the costly habit. The individual surrenders his self-respect to the addiction and also losses trustworthiness in the society. As discussed earlier, alcohol and criminal behavior go hand in hand. Substance abusers have problems managing their emotions and typically show more aggressive behavior. This….

Bibliography

NIAAA. (2003), "Underage Drinking: A major Public Health Challenge," Accessed on March 2nd 2005, http://www.niaaa.nih.gov/publications/aa59.htm

Janet C. Greenblatt, "Patterns of Alcohol use Among Adolescents and Associations with Emotional and Behavioral Problems," Accessed on March 3rd 2005, http://www.health.org/govstudy/adolemotion/

Shope, Jean T. (2004), "Adolescent Developmental Antecedents of Risky Driving Among Young adults," Journal of Studies on Alcohol, Vol 65, Number 1, Pg 84

Holly Harner (2003), "Sexual Violence and Adolescents," Accessed on March 3rd 2005, http://www.vaw.umn.edu/documents/vawnet/adolescent/aradolescent.html#id2634574

Health Science in Regards to Drugs and Alcohol

Health Science in egards to Drugs and Alcohol Legalization of drugs When Colorado and Washington legalized the use of marijuana for recreational purposes, issues related to legalization of all drugs became subject of public debate. Those who voted for legalization of Marijuana in these two states argued that legalization of these drugs would generate revenue, deter black market activities, and check against lose of tax resources used by law enforcement agencies (Will, 2012). These younger and liberal voters averred that drug enforcement unfairly targeted minority groups and that the current laws led to greater crimes because of the demand for illegal drugs. Those of opposing view opined that criminalization of recreational drugs could help lower rate of use and abuse hence decrease in addictions and problems associated with it. Opponents of legalization of drugs were older and more conservative. The current policy detailing the war on drugs has failed to live to expectations….

Ennett S.T., et al. (2013). How effective is drug abuse resistance education? A meta-analysis of Project DARE outcome evaluations. Retrieved February 27, 2012 from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1615171/

Fareed Zakaria, (2012). Incarceration Nation. Retrieved February 27, 2012 from http://www.time.com/time/magazine/article/0,9171,2109777,00.html

Fingarette, H. (1990). Why We Should Reject the Disease Concept of Alcoholism. In R.C. Engs,

(Ed.), Controversies in the Addictions Field. (P.48). Dubuque, IA: Kendall-Hunt.

Physical Abuse in Relationships Due to Drugs and Alcohol

Physical Abuse in Relationships Due to Drugs and Alcohol Family violence has become a significant public health issue in the United States (ood pp). Many believe the reason for the problem of domestic violence within the United States is because the U.S. has the highest substance abuse rate of any industrialized nation (Drug pp). There have been numerous studies to support a relationship between substance abuse and domestic violence. According to many researchers and physicians, such as Cathy L. Baldwin-Johnson, who spoke before the annual meeting of the American Academy of Family Physicians, partner violence is the most common form of domestic violence, and occurs within all ethnic groups, economic classes, religions, and age groups, as well as in homosexual relationships (ood pp). Ninety-five percent of all victims of violence are women, and approximately half of all women in the United States will be abused by a current or former partner sometime….

Drug Addiction and Drug Abuse. (2005). The Columbia Encyclopedia. Retrieved July 03, 2005 from HighBeam Research Library Web site.

Hien, Denise; Hien, Nina M. (1998, August). Women, violence with intimates, and substance abuse: relevant theory, empirical findings, and recommendations for future research. American Journal of Drug and Alcohol Abuse. Retrieved July 03, 2005 from: http://findarticles.com/p/articles/mi_m0978/is_n3_v24/ai_21154249

Martin, Sandra L.; Beaumont, Jennifer L.; Kupper, Lawrence L. (2003, August).

Substance use before and during pregnancy: links to intimate partner violence. American Journal of Drug and Alcohol Abuse. Retrieved July 03, 2005 from: http://findarticles.com/p/articles/mi_m0978/is_3_29/ai_109351419

Drug and Alcohol Abuse

Drug and alcohol abuse is a serious problem among many young people for a variety of reasons. First, statistics show that drugs and alcohol are being abused by a large segment of the teen and young adult population, which can greatly increase their likelihood of a premature death. Secondly, many things can happen to young adults that do not lead to death, but can ruin their lives. Finally, drug and alcohol abuse can have a serious impact on relationships with friends and family. According to the National Drug Statistics Summary, approximately 14 million Americans used illegal drugs in 2000. Among the teenagers interviewed for the survey, nearly ten percent had used drugs in the month before the interview. The findings for alcohol abuse were even higher. Nearly half of Americans over the age of twelve reported that they drank alcoholic beverages. This is a serious issue. First, the drugs in themselves….

Hafetz, David. Jacqueline and Amadeo: Chasing Hope. Austin American Statesman. 2002 May. February 13, 2010.

National Drug Statistics Summary. Adolescent Substance Abuse Knowledge Base. 2007. February 13, 2010.

Drug Alcohol Abuse Drug and Alcohol

Substance use is frequently associated with child abuse and domestic violence. It also is a leading contributor to marital dissatisfaction, family breakups and rejection of family members. The importance of the family in understanding alcohol and drug use and abuse is underlined by these highly destructive consequences of alcohol and drug dependency on the abuser and the family. (Lala; Straussner; Fewell, 17) Peer Group plays an important part in resolving the problem as they are able to take the drug or alcohol abuser more into confidence compared to others since most people associate themselves with their respective peer group in terms of habits, tastes and concerns. It has been demonstrated that a drug abuser will definitely abide by a member of the peer group to which he belongs and obey requests of abstinence more than anyone else. Educational system also plays an important role in tackling the prevalence of the….

Ammerman, Robert T; Ammerman, Peggy J. Ott; Tarter, Ralph E. (1999) "Prevention and Societal Impact of Drug and Alcohol Abuse" Routledge.

Lala, Shulamith; Straussner, Ashenberg; Fewell, Christine Huff. (2006) "Impact of Substance

Abuse on Children and Families: Research" Haworth Press.

Laufer, William S. The Legacy of Anomie Theory: Advances in Criminological Theory.

Drug and Alcohol the Effects

And they can often escape into substance abuse and addiction" (Study reveals rise in drug, alcohol abuse during economic downturn). One of the most important ways in which an increasing rate of drug and alcohol abuse and addiction affects the economy is the spiraling cost of healthcare and rehabilitation. The increase in addictions also creates a gap between the need for treatment and rehabilitation and available resources. This in turn places economic pressure on state and local government. This is especially difficult to maintain in a recessionary economic climate. "States, local governments, and non-profits are all facing tremendous budget shortfalls -- and they are cutting the resources to help this growing group of addicts in trouble, just when they need it the most" (Study reveals rise in drug, alcohol abuse during economic downturn). The following illustrations provide a clear indication of the amounts that have been spent on alcohol and drug….

Allen J. ( 2006) Drugs a Factor in Many Sexual Assaults, Study Says. Retrieved September 27, 2009, from http://www.redorbit.com/news/health/501383/drugs_a_factor_in_many_sexual_assaults_study_says/

Bennet W. (1999) the Index of Leading Cultural Indicators. New York: Broadway

Drug addiction. Retrieved September 27, 2009, from http://www.economicexpert.com/a/Drug:addiction.htm

Drug and Alcohol Dependency

Alcohol and substance abuse is a prevalent problem among youth. Effects of alcohol and substance abuse range from mental health problems like depression and suicide ideation to dating violence, to poor academic performance (adliff, Wheaton, obinson, & Morris, 2012). Early exposure to substance and alcohol abuse in the home may lead to an earlier instance of drug and alcohol abuse. This is because of the higher degree of availability and potential lack of parental involvement. This research paper aims to highlight the various ways in which drug and alcohol abuse affect youth from within and outside the home. Effects of alcohol and substance abuse on high school youth Academic failure can be one effect of substance and alcohol abuse. One study notes the lack of school commitment from youth experimenting with drugs and alcohol (Kelly et al., 2015, p. 627). The study examined gender, and substance/alcohol abuse in a 30-day period, noting….

Benjet, C., Borges, G., Medina-Mora, M., & Mendez, E. (2013). Chronic childhood adversity and stages of substance use involvement in adolescents. Drug and Alcohol Dependence, 131(1-2), 85-91. http://dx.doi.org/10.1016/j.drugalcdep.2012.12.002

Epstein-Ngo, Q., Cunningham, R., Whiteside, L., Chermack, S., Booth, B., Zimmerman, M., & Walton, M. (2013). A daily calendar analysis of substance use and dating violence among high risk urban youth. Drug And Alcohol Dependence, 130(1-3), 194-200. http://dx.doi.org/10.1016/j.drugalcdep.2012.11.006

Gauffin, K., Vinnerljung, B., Fridell, M., Hesse, M., & Hjern, A. (2013). Childhood socio-economic status, school failure and drug abuse: a Swedish national cohort study. Addiction, 108(8), 1441-1449. http://dx.doi.org/10.1111/add.12169

Ivanov, I., Liu, X., Shulz, K., Fan, J., London, E., & Friston, K. et al. (2012). Parental substance abuse and function of the motivation and behavioral inhibition systems in drug-naive youth. Psychiatry Research: Neuroimaging, 201(2), 128-135. http://dx.doi.org/10.1016/j.pscychresns.2011.08.004

Drug and Alcohol Abuse in the Military

Army Substance Abuse Program, in terms of the program's history, its employment requirements, and the rationale behind them. It looks at various jobs within the hierarchy of this program, from the commanders responsible for implementing the program on the level of installations or garrisons, to the trained personnel taking urine samples. By way of demonstrating the utility of the continued education requirement even for the personnel collecting urine, the paper notes the existence of such widespread willingness to deceive testing, and then reviews recent peer-reviewed studies with potential relevance for successful implementation of Army Substance Abuse Program theories, curricula, and policies. Introduction The Army Center for Substance Abuse Programs was first established in 1971 in response to a law requiring the Secretary of Defense to identify, treat, and rehabilitate members of the U.S. military determined to be dependent upon alcohol or illicit drugs; similar legislation followed to require the same standards….

Lande, R.G.; Marin, B. (2009) Biomarker characteristics of alcohol use in the U.S. Army. J Addict Diseases 28: 158-163. DOI:10.1080/10550880902772506

Larson, M.J.; Wooten, N.R.; Adams, R.S.; et al. (2012). Military combat deployments and substance use: Review and future directions. J Soc Work Pract Addict 12: 6-27. doi: 10.1080/1533256X.2012.647586

McFarling, L.; D'Angelo, M.; Drain, M.; et al. (2011). Stigma as a barrier to substance abuse and mental health treatment. Military Psychology 23: 1-5 http://dx.doi.org/10.1080/08995605.2011.534397

Milliken, C.S.; Auchterlonie, J.L.; Hoge, C.W. (2007). Longitudinal assessment of mental health problems among active and reserve component soldiers returning from the Iraq War. JAMA 298: 2141-2148 doi:10.1001/jama.298.18.2141

Connection Between Combat Exposure and Drug and Alcohol Abuse

Combat and Substance Abuse Posttraumatic stress disorder (PTSD), as a consequence of combat experience, is believed to be a significant risk factor for substance abuse. This theory has been undermined to some extent by recent findings which suggest mental illness, apart from PTSD, may be a stronger predictor. Although combat-related PTSD may significantly contribute to the prevalence of substance abuse among veterans, the dominant substance abuse risks are the same for both civilians and combat veterans. This conclusion suggests than combat may represent a minor risk factor for substance abuse. The Association between Combat and Substance Abuse Veterans of the wars in Iraq and Afghanistan are faced with many of the same problems that previous combat veterans have had to face, including posttraumatic stress disorder (PTSD) and traumatic brain injury (TBI). While most veterans suffering from these conditions will successfully cope with the challenges they face through treatment and social support networks, others….

Adamou, Marios C. And Hale, Anthony S. (2003). PTSD and the law of psychiatric injury and England and Wales: Finally coming closer? Journal of the American Academy of Psychiatry Law, 31, 327-332.

Bagalman, Erin. (2011). Suicide, PTSD, and substance use among OEF/OIF veterans using VA Health Care: Facts and figures. Congressional Research Service. Retrieved 10 Jan. 2013 from http://www.fas.org/sgp/crs/misc/R41921.pdf .

National Center for PTSD. (2011). PTSD and substance abuse in veterans. PTSD.VA.gov. Retrieved 10 Jan. 2013 from http://www.ptsd.va.gov/public/pages/ptsd_substance_abuse_veterans.asp .

Nooner, Kate B., Linares, L. Oriana., Batinjane, Jessica, Kramer, Rachel A., Silva, Raul., and Cloitre, Marylene. (2012). Factors related to posttraumatic stress disorder in adolescence. Trauma, Violence, & Abuse, 13(3), 153-166.

Alcohol Tobacco & Drug Use

S. provide funds for staff development on drug use and alcohol use by school-age children. But only 26% of elementary school classes and required middle school and high school health education courses had a teacher that had received "staff development on alcohol or other drug-use prevention" (SHIPPS). Still, SHIPPS reports that 91.4% of high schools and 80.4% of middle schools surveyed teach the "benefits of not using alcohol" and 90.3% of high schools and 79.4% of middle schools teach the "benefits of not using illegal drugs." These data are based on schools that have "required instruction" in those areas of health education. An article in the Journal of School Health (Summerlin-Long, 2008) details "tobacco-free school" (TFS) policies; the article references "positive reports" from "key informants" in 46 school districts in North Carolina that had passed TFS policies between December 2001 and August 2005. This article is particularly pertinent because of North….

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Alcoholism & Drug Abuse Weekly. (2002). Teenagers abusing cough syrup. Retrieved March 1, 2009, at http://www.accessmylibrary.com/coms2/summary_0286-2173465_ITM .

Brooks, Ashley, Gaier Larkin, Elizabeth M., Kishore, Sonal, & Frank, Scott. (2008).

Cigars, Cigarettes, and Adolescents. American Journal of Health Behavior, 32(6),

Bryant, Alison L. (2003). How Academic Achievement, Attitudes, and Behaviors Relate

Drug Usage the Use Drugs

Drug addiction is not merely a failure of will or weakness in character, however having this 'brain disease' does not absolve the addict of responsibility for his or her behavior, but it does explain why an addict feels compelled to continue using drugs (Leshner 2001). Environmental cues that surround an individual's initial drug use and development of the addiction, actually become "conditioned" to the drug use and thus are critical to the problem of addiction (Leshner 2001). Therefore, when those cues are present at a later time, "they elicit anticipation of a drug experience and thus generate tremendous drug craving" (Leshner 2001). This type of cue-induces craving is one of the most frequent causes of drug use relapses, independently of whether drugs are available and even after years of abstinence (Leshner 2001). In March 2006, it was reported that researchers from Liverpool, England discovered a gene that directly affects the risk….

Changeux, Jean-Pierre. (1998 March 22). Drug use and abuse. Daedalus. Retrieved November 06, 2006 from HighBeam Research Library.

Eaves, Lindon J. (2005 July 01). Familial influences on alcohol use in adolescent female twins: testing for genetic and environmental interactions. Journal of Studies on Alcohol. Retrieved November 06, 2006 from HighBeam Research Library.

Goldman, Erik. (2005 July 01). Genetic tests could improve future drug abuse treatment. Family Practice News. Retrieved November 06, 2006 from HighBeam Research Library.

Heroin Addiction Cuts Across All Social Boundaries, Caron Foundation Study Reports.

Drug Free Workplace in Favor

What further makes interpretation of results difficult to precisely define quantify is that the amount of drug stores depends on the nature of the drug itself, the duration of the ingestion of the drug, and the composition of the tissue holding the drug and the frequency of use. The greater the incidence of drug use the more permanent the level of toxins and chemicals in tissues throughout the body, and therefore the greater the probability of catching chronic drug users in drug testing. Thea difficult part of using drug tests periodically is the longitudinally there may be peaks and valleys to the incidence of drug abuse. Companies have begun surprise inspections of their workers in the most potentially dangerous occupations including forklift workers, construction workers, airline pilots, and heavy equipment workers. Despite these shortcomings of tests, the advances made in drug testing technologies are gradually overcoming these obstacles related to….

Alleyne, B.C., P. Stuart, and R. Copes. (1991) Alcohol and other drug use in occupational fatalities. Journal of occupational medicine (Baltimore) 33(4):496-500, 1991.

Gerber, J.K. And G.S. Yacoubian, Jr. (2002). An assessment of drug testing within the construction industry. Gerber, J.K. And G.S. Yacoubian, Jr. J Drug Education 32(1):53-68

Koch, K. (1998). "Drug Testing." November 20, 1998

Kelly, T.H., R.W. Foltin, and M.W. Fischman. (1991) Effects of alcohol on human behavior: implications for the workplace. Drugs in the workplace: research and evaluation data. Vol. 11, National Institute on Drug Abuse. Rockville, Maryland 1991. pp. 129-146.

Sports - Drugs

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Alcohol and substance abuse is a prevalent problem among youth. Effects of alcohol and substance abuse range from mental health problems like depression and suicide ideation to dating violence,…

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Army Substance Abuse Program, in terms of the program's history, its employment requirements, and the rationale behind them. It looks at various jobs within the hierarchy of this…

S. provide funds for staff development on drug use and alcohol use by school-age children. But only 26% of elementary school classes and required middle school and high school…

Drug addiction is not merely a failure of will or weakness in character, however having this 'brain disease' does not absolve the addict of responsibility for his or…

What further makes interpretation of results difficult to precisely define quantify is that the amount of drug stores depends on the nature of the drug itself, the duration…

Introduction Of Drugs And Alcohol Essay

Table of Contents Introduction to Drugs and Alcohol 2 Overview 2 I. Workplace Factors 3 II. Workplace Performance & Behavior 4 III. Workplace Role 5 RECOMMENDATION 6 Workplace Policies and Drug Testing 7 Policy and Regulations on Alcohol and drug abuse 7 Employee Education/Health Promotion 8 Works Cited 9 Employer’s Guide for a Drug-free Workplace Introduction to Drugs and Alcohol In order to understand drug and alcohol use, it is important to be clear about what we mean by the terms ‘drugs’ and ‘alcohol. Alcohol is a legal, sedative drug, which changes the way we think, feel and do. It can make you more relaxed or it can take away your judgment. For most countries, like Canada, it is legal for adults over 18 years to buy and drink. There are many different types of alcoholic drinks such as beer, wine and spirits (whiskey, vodka, gin etc.). Drugs are chemicals which, when taken into our bodies, alters normal bodily function, resulting any psychological and behavioral change. Some drugs are legal, such as caffeine, tobacco/nicotine and alcohol. Other drugs like cannabis, cocaine, ecstasy and heroin are illegal. Legal drugs also include medicines that are available over the counter at a chemist or prescribed by a doctor. A person can misuse these drugs by taking them in a way, which they are not supposed to be used or in amounts not prescribed by their doctor. Overview Alcohol and drug problems (sometimes also called substance abuse or misuse) are common in a

Drugs and its Offenders Essay

7 Works Cited

The United States has the world's highest incarceration rate. With five percent of the world's population, our country houses nearly twenty-five percent of the world's reported prisoners. Currently there are approximately two million people in American prisons or jails. Since 1984 the prison population for drug offenders has risen from ten percent to now over thirty percent of the total prison population. Federal prisons were estimated to hold 179,204 sentenced inmates in 2007; 95,446 for drug offenses. State prisons held a total of 1,296,700 inmates in 2005; 253,300 for drug offenses. Sixty percent of the drug offenders in prisons are nonviolent and were purely in prison because of drug offenses (Drug War Facts). The question then arises,

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Countries all over the world are dealing with a rise of drug use and drug-related public health concerns. Many nations adopt vaguely similar methods of battling the “War on Drugs”, from strict border control to harsh criminal punishments for drug-related offenders, violent or not. Even with these efforts put in place, many places are not seeing the desired results. Drug use is mainly treated like a crime, and that may be the problem. Countries that have concerns with rising drug use among their citizens should follow Portugal in decriminalizing the possession and use of small quantities of all illicit drugs.

The Cost Of Substance Abuse In Canada Case Study

“Substance use disorders” or “substance-related disorders” are intended synonymously and are used interchangeably when referring to the broad category of addiction to psychoactive substances. Additionally, the word “drug” should be considered in the context in which it appears and can refer to alcohol specifically and/or other psychoactive substances such as cocaine or heroin etc. Again, this is because of the large overlap within the broader category of substance use and the high prevalence of polysubstance use. For the sake of clarity, “drug” as used in North America to generally refer to any illicit or controlled substance has been avoided. Instead, “medication” will be used to denote a prescribed substance used to treat physical symptoms. However, many legally prescribed medications (such as morphine) can and are abused and have addictive quality, making them just as devastating as “street drugs” or alcohol (Compton & Volkow, 2006).

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1b. List and describe briefly the major structures of the brain, as presented in your textbook, including the function of those elements that are most related to psychoactive drug reaction.

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Substance abuse disorders are common in our society. It is a disorder that each one of us will most likely experience through a family member, friend, or our self. I felt very drawn to this topic due to the fact that I have a family that has background of substance abuse and I myself have battle the demon. Not until I struggled with my own addiction did I become more tolerable and understanding to those that have a substance abuse disorder. Substance abuse is not something anyone wants to have; it is a disorder that takes control of a person’s life. It is a beast that tears a person apart; from their being to the lives of their loved ones. This disorder is not biased in anyway; rich or poor, male or female, employed or unemployed, young or

The Who, What, and Why of Substance Abuse Essay

Substance abuse is the habitual use of mind altering substances (Substances). Addicts have a false or altered look on reality; they need help seeing what is wrong with the life style they are living. Nikki Sixx once said,” Addiction- When you can give something up at any time, as long as it’s next Tuesday!” Recovery is teaching a person to break old habits. Substance abuse counselors are very important, not only in the mental health field, but in society as well.

Deontological View On Drugs And Alcohol Use Essay

Drug and alcohol use is considered to be one of the major issues in the world today. Drugs can impair us, causing us to make poor decisions as well as cause permanent damage to the body. Deontology is an ethical theory that maintains that actions are not justified by their consequences; one should do what is morally right as it is their duty. What is morally right in the eyes of a deontologist is determined by universal moral laws, cultural norms, and religious views. This paper will analyze the morality of drug and alcohol use through these views.

Substance Abuse Prevention Paper

Prevention methods for substance abuse are taught to children as early in their kindergarten years and follow throughout their lifetime. Current programs available are school-based programs, parent and family, work programs and community and public media campaigns.

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13 Works Cited

Substance abuse and addiction have become a social problem that afflicts millions of individuals and disrupts the lives of their families and friends. Just one example reveals the extent of the problem: in the United States each year, more women and men die of smoking related lung cancer than of colon, breast and prostate cancers combined (Kola & Kruszynski, 2010). In addition to the personal impact of so much illness and early death, there are dire social costs: huge expenses for medical and social services; millions of hours lost in the workplace; elevated rates of crime associated with illicit drugs; and scores of children who are damaged by their parents’ substance abuse behavior (Lee, 2010). This paper will look at

Drug and Alcohol Abuse Essay

Alcohol abuse is a serious problem, driving while drunk or under the influence of drugs is an even bigger problem that shouldn’t be taken lightly. Abusing either one of these substances can lead to the death of you or the death of someone else or even cause a major change in their life like Jacqueline’s story, her whole life has been changed because of another person’s ignorance and carelessness. Therefore, you should know the facts about drug and alcohol abuse before you do something you may regret for the rest of your life.

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A drug is a chemical substance applied into treating, diagnosing and preventing one from disease infections or a substance that is used by a person to enhance his or her physical and mental state in the perceived effect. Drugs used for different purposes and their effect depend on which cause for usage. It causes both positive and negative consequences directly to the user and in the long-run it affects the whole society or community. Drug addiction is the activity of uncontrollable dependence on a substance by the user no matter the harm caused by its usage. It is a habit that has been in many years hard to curb especially among the youths. “We must recognize that substance abuse and addiction is a disease, not a moral failing or easily abandoned self-indulgence,” (Califano, 2008).The cases of drug abuse have been on the rise over the recent years and resulted in crimes. The cases have a great effect affected the society in general since the reliable energetic youths have turned to drug abuse. However, some measures have been initiated to mitigate, curb and treat drug addiction in the society as outlined in the essay.

Essay on Alcoholism and Alcohol Abuse

32 Works Cited

Alcohol is the number one drug problem among America’s youth. More senior high school students use alcohol than any other psychoactive drug. Family doctors, pediatricians, schoolteachers, and parents know that alcohol is overwhelmingly the drug of choice among today’s youth, although trendier substances such as cocaine are often given more attention in the headlines (Carla Felsted, p. vii). Furthermore, it is widely acknowledged that drinking alcohol is a part of the youth culture in America; it may also be understood as a culturally conditioned and socially controlled behavior.

Drugs and Alcohol Essay

Drugs are heavily used throughout the entire world. However, it is important to understand and not undermine the variability in which drugs are used. It is clear some are for distinct medical treatment and others are for recreational use. In the United States, marijuana has been and continues to be a very controversial drug. Some states have allowed marijuana consumption for medicinal purposes, while others have completely outlawed the drug. Those who are against the legalization and regulation of marijuana suggest the economical and health risk associated with consumption of the drug are too high. Although there is risk involved with the legalization of the marijuana, our country has already been risking too much banning the drug.

Alcohol and Drug Abuse Essay

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Alcohol and drugs have been known to have consequences, but once the use turns into abuse it can lead to grave danger. People who are abusive with are likely to have medical struggles along the way due to the damaging effects of the substance. Often disorders seem to exist with alcohol and drug abuse. Use of alcohol and drugs can turn into more than just a one time thing and can lead to addiction and abuse. The risk of drug abuse grows substantially during a time of change. There are different factors or reasons that can lead to alcohol and drug abuse, whether you’re an adult or a teen. Reasons may include a divorce, loss of a job as an adult, while teens may do so due to moving or changing schools. Young teens and teenagers all together are…

Drugs And Alcohol Abuse

Firstly, I have come from a family with a history of drug or alcohol abuse, however I have never abused any substance but believe that genetic factors play a huge roll in whether or not an individual becomes an addict. The United States has an extremely large rate of people that report drug abuse or that admit to being addicted in general, it is widely expanded with drugs whether it be marijuana or heroin. I deliberate that the reason we all see so much use of methamphetamines is because it is…

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Drug abuse and addiction have impacted the world that we live in today. There are too many people that have a problem with drugs and they either refuse to get help or do not want to get help since this drug has a grasp on them and will not let go. Whatever drug they are on, does not just affect them but it also affects the people that are close to them and their families. This also leads to their children seeing this happen and thinking it is either okay to do or they think it is cool. So they…

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The big problem that Toledo faces now is drug and alcohol abuse. The most common drugs you hear about in Toledo, Ohio is heroin, cocaine and china white. China white is a mixture of the drug heroin and the narcotic fentanyl. These common drugs along with alcohol is a common problem anywhere, but this is the biggest problem that Toledo faces right now. Drug and alcohol abuse can lead to many things, and it commonly leads to negative outcomes.There are several solutions to stop drug and alcohol…

Alcohol And Drug Abuse Essay

Drug and Alcohol Abuse Drugs are not something that plagues the local area, it is all around the world. Drugs have been around for a very long time. Drugs have been hurting people mentally, physically, and emotionally for centuries whether illegal or legal. Some say that drugs are okay, it causes no harm, but the person taking drug. Taking a certain amount or the wrong drugs can get people in trouble or even kill them. Drugs can ruin peoples life’s. The average age of people who first…

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Drug and alcohol abuse is one of the most important social issues in this novel. Drug abuse refers to the excessive or addictive use of drugs for nonmedical purposes (“Drug Abuse,” 2015). Drug use can become a social problem when an individual becomes impaired through drug-taking behavior (Busse & Riley, 2008, p. 21). Drug and alcohol abuse lead to many serious consequences. The emotional, physical, social, psychological, and intellectual health of many children and adults are impaired and…

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The topic of Alcohol and Drug abuse made an impact on me since my father was an alcoholic until just recently. My father wasn’t the type to get drunk in front of his family so he wouldn’t drink so much to make himself drunk. In a way, he did somewhat know how to control his drinking, but he still did drink more than someone his age should and anyway you cut it, alcohol was still bad for his health.. At first I didn’t know what was so addicting about Alcohol or what inside it made it so addicting…

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Federal Government should help with drug and alcohol abuse epidemic in adolescence in the American Indians and Alaska Natives (AIAN) community. According to Substance Abuse and Mental Health Services Administration (SAMHSA) in 2011, there were over twenty million youth at the age of twelve and older, who were using alcohol and drugs. Also, eight percent of the population aged twelve or older were classified with substance dependence or abuse (SAMSHA, 2011). Heavy drinking has long been a public…

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Essay on Drugs

Good Argumentative Essay About Drugs And Alcohol

Type of paper: Argumentative Essay

Topic: Drugs , Alcohol Abuse , Abuse , Bullying , Alcohol , Violence , Life , Alcoholism

Words: 1000

Published: 03/14/2020

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Introduction

Many people continue to abuse drugs and consume a lot of alcohol even as the campaign against them continues. An approximate of 500,000 people die from drug abuse and alcoholism on a yearly basis. The two are highly addictive and form part of what is affecting the society most. The paper will discuss the effects of drugs and alcohol and examine their negative effects on the individual and society. Drugs and alcohol pose negative effects on people’s health, their interactions with others in the society and inhibits them from leading a successful life.

The negatives of drugs and alcohol

First, the two have adverse effects on the heath of an individual. A lot of alcohol consumption weakens a person’s immune system and could lead to death when body organs eventually fail to work. They cause liver cirrhosis because they scar the liver tissues which replace the normal functioning ones. Women, especially, who drink a lot are at a higher risk of getting liver cirrhosis. The kidney, also, is a victim to the excessive consumption of alcohol and drug abuse. After a while it ceases to function and leads to many kidney complications, the worst being kidney failure. In addition, research has indicated that the abuse of certain drugs such as cocaine and Marijuana leads to infections in the inner body organs. The lungs are crucial to the supply of oxygen. When they are infected, a person may develop breathing problems because the infections will hinder the inhalation and exhalation process that happens in them. Drugs such as methamphetamine lead to difficulties in breathing. The drug is common on the streets and is referred to as crank. It also causes skin irritability, panic attacks and often results in tooth loss because of dehydration of the body and mouth. The panic attacks of sleeplessness that is damaging to a person’s health. Second, drug abuse and alcohol consumption can result to an abuse victim’s failure to succeed in life. Most of the time, people argue that a little puff or gulp of drugs and alcohol cannot be harmful. The observation is true but is limited by the fact that the two are highly addictive. Most addicts start of as social drinkers, smokers or sniffers. They do so on rare occasions, but they become perpetual alcohol drinkers or drug abusers overtime. In the end, their productivity in life is limited, and they end up failing in everything they do. For instance, most young people drop out of school because of drug abuse. In states such as New Orleans, many teenagers have dropped out of school because of cocaine, heroin and Marijuana use. Moreover, there are people who get fired from their jobs or lose their families because of alcoholism(Klingner, Donald, and Nancy, 7). Others misuse their savings and end up being poverty stricken because they waste their resources on alcohol and drugs. The recklessness caused by the two can have adverse effects on individuals who use them. For instance, drug and alcohol use leads to instances of unsafe sex practices and accidents. Most people who are high never take precautions in their lives and end up ruining them. The misconception about drugs is that they affect people who have no control or somehow belong to a lower class in society. Drugs affect everyone who uses them and can damage the most honorable of people. They lead to the spread of diseases such as HIV, which can ruin an individual’s life. Research has shown that 30% of car accidents are the result of drunk drivers. Such recklessness is what destroys good lives and is mostly perpetrated by drugs and alcohol. Besides, individuals tend to lose focus of their life goals when they abuse drugs and consume alcohol. Theylead to short-sightedness in life because an individual exists in a careless state when he or she is high of drugs and alcohol. Third, drug and alcohol affects how people interact with other around them. Often, victims to alcoholism and drug addiction live a solitary, lonely life. The reason is that they fail to mingle with other people. They are prone to violent outbursts and irritable behavior that makes them dangerous to those around them. The only company an addicted individual can keep is with other addicts. Their substance use makes them unacceptable in the society. In some cases, addicts and alcoholics lose the people in their close circles and end up alone, or with strangers who also use drugs and are alcoholics. The violent nature they adopt is not healthy for building of close relationships with the people around them. Also, drug use and alcoholism leads to involvement in criminal activities and prostitution. The reason is that is the only company that can accept addicts and alcoholics. Once an individual becomes broke, and they have to have drugs, they will do anything to acquire the money needed to finance their lifestyles. Most will end up doing despicable things in a bid to get high because the withdrawal symptoms that are hard to control. They will be involved in a series of thefts, robberies and sexual trades that will earn their money. The sad end is death or a prison term. Some individuals completely change and become hard core criminals when they are deeply rooted to alcoholism and drug use. Some are redeemable.

Alcohol and drug use is bad because of what it does to its victims as discussed in the above paper. However, it is not incurable. Rehabilitation centers exist to ensure people who are willing to change get cured and go back to live normal lives in the society. Also, therapy exists as a means of helping victims to establish where the origin of the problem is for them to find complete redemption. The methods of cure only exist for the individuals who stop living in denial and take responsibility for that in which they indulge.

Klingner, Donald E, and Nancy G. O'Neill. Workplace Drug Abuse and Aids: A Guide to Human Resource Management Policy and Practice. New York: Quorum Books, 1991. Print.

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Essay: Impact of Alcohol, Tobacco And Drug Abuse on Youth

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Impact of Alcohol, Tobacco And Drug Abuse on Youth

Alcohol, tobacco and other drugs are affect youth negatively. Youth especially student’s e.g. secondary and tertiary students abuse alcohol, tobacco and other Drugs. Drugs such as tobacco, cocaine and marijuana are the major drugs which students abuse or use. Youth may end up drinking alcohol and using drugs because of various situations or reasons e.g. youth especially school going drink alcohol, use tobacco and other drug as a result of peer pressure because they may want to feel grown up among their peers, some youth use drugs to relieve boredom and give themselves personal excitement, some use drugs to rebel and get violent without any fear of people or authority, some use drugs to experiment, some use drugs and drink alcohol because their parents also drink alcohol so they end up indulging in the practise as well, social background may also influence youths to use drugs and to drink alcohol e.g. if they are many drug dealers and bottle stores around its easier for youths to indulge in the use of this drugs and lastly some youth may drink alcohol and abuse drugs to feel pleasure and escape the pressures of life or to alter their view of reality. Youth who get into drugs may get it from a friend’s friend, who also got it from his friend’s friend and so on this is to say that drugs are not of easy access because they are illegal. At the end of this long line of friends is a dealer who is making money out of destroying young people futures. The use of alcohol, tobacco and other drugs has negative impacts amongst the students who abuse this substances e.g. excessive alcohol consumption and the abuse of drugs are dangerous because alcohol and drug abuse can affect health and ability to function and think properly, almost every system in the body can be negatively affected by use of drugs and drinking of alcohol. Alcohol can cause cancer, liver disease, heart attacks and brain damage, to mention a few. Alcohol, tobacco and other drug use does not only affect youth especially students’ health wise it also affects their academic performance, it also affect them financially, psychologically, physically and ultimately students may suffer some legal consequences. Youth more so teens, who engage in sexual intercourse and drug abuse including abuse of alcohol and tobacco, are more likely than youth who abstain from such activities to become depressed, have suicidal thoughts and or even attempt suicide.

HEALTH EFFECTS OF ALCOHOL, TOBACCO AND DIFFERENT DRUG USE The use of alcohol, tobacco and other drugs has detrimental effects on health of the youth which may turn out to be fatal. The type of drugs which students commonly use are Stimulants (drugs that produce alertness, high energy, more awake and confident e.g. cocaine, amphetamines, caffeine) and Hallucinogens (give strange and intense visions called hallucinations) ALCOHOL

The scientific name for alcohol that people drink is ethyl alcohol or ethanol. Beer, wine, and liquor all contain ethyl alcohol. Other types of alcohol, like rubbing alcohol are poisonous if ingested. . Excess alcohol is the most common cause of preventable death. Alcohol is highly toxic to almost every organ in the body but when alcohol is taken in allowed limits amounts it is detoxified by the liver and therefore does little or no harm to the body. Alcoholic drinks contain ethyl alcohol and it is metabolized in the body to acetaldehyde. Both ethanol and acetaldehyde interfere with normal functioning of organs in the body including the heart and the liver and therefore if the liver and the heart get damaged disease occur which may eventually kill, teenagers maybe more prone to this effects in the youth as their organs are still developing thus toxic substances from alcohol damage their body organs. When people drink too much, with time they risk becoming addicted to alcohol. This is called alcoholism, or alcohol dependence. It’s a disease, and it can happen at any age, Common signs include, loss of control not being able to stop or cut down drinking, not feeling well after heavy drinking (upset stomach, sweating, shakiness, or nervousness), neglecting activities giving up or cutting back on other activities. Binge drinking happens when someone drinks more than four (for women) or five (for men) alcoholic drinks in about two hours, with the intention to getting drunk. Binge drinking is the most harmful type of drinking. It usually happens at teen or student parties TOBACCO The dangers of smoking are so great, but because of it governments get a lot of tax money from tobacco and cigarettes manufacturers, they are less hesitant to ban it totally. Government and society is aware of the danger that is why they made it illegal for teens to possess and use cigarettes. Smoking of tobacco can cause many with many diseases like respiratory and heart disease including, respiratory infections, lung cancer as well as cancer of the larynx, pancreas, stomach, & uterine cervix, bronchitis, emphysema and stillborn or premature children ().Smoking causes surges in the concentrations of catecholamine’s (the stimulator chemical messengers of the autonomic nervous system) as well as increases in carbon monoxide in the blood. Both of these short- term effects can exacerbate existing heart disease, resulting, for instance, in attacks of angina (chest pain). Nicotine raises blood pressure and heart rate, requiring the heart to work harder. It also constricts the coronary arteries, thereby lessening the supply of blood and oxygen to the heart muscle. It also promotes irregular heartbeats (cardiac arrhythmias). Smokers are not the only people harmed by tobacco. Toxic fumes from cigarettes pose a health threat to all those around smoker’s family, friends, and. Because the organic material in tobacco does not burn completely, smoke contains many toxic chemicals, including carbon monoxide, nicotine, and tar. As a result of this exposure, smokers’ children have more colds and flu, and they are more likely to take up smoking themselves when they grow up. Smokers also affect other people as well e.g. passive smoking. This is the involuntary inhaling of smoke from other people cigarettes and we all suffer when we have people smoking around us. It is called second-hand smoking and it is known to be even more dangerous than smoking itself COCAINE

Use of cocaine has increased among youth over the years, along with the myth that the drug is relatively safe, especially when it is sniffed rather than injected or smoked as ‘crack.’ In fact, no matter how it is used, cocaine can kill. It can disturb the heart’s rhythm and cause chest pain, heart attacks, and even sudden death. These effects on the heart can cause death even in the absence of any seizures. Even in the absence of underlying heart disease, a single use of only a small amount of the drug has been known to be fatal. Cocaine use is not healthful for anyone, but especially for certain groups like the youth. Although the drug has been shown to impair the function of normal hearts, it seems even more likely to cause death in people with any underlying heart disease. When pregnant women use cocaine, they not only raise the likelihood of having a miscarriage, a premature delivery, or a low-birth-weight baby, but also of having a baby with a congenital heart abnormality, especially an atrial-septal or ventricular-septal defect.

Use of cocaine raises blood pressure, constricts blood vessels, and speeds up heart rate. It may also make blood cells called platelets more likely to clump and form the blood clots that provoke many heart attacks. In addition, cocaine’s effects on the nervous system disrupt the normal rhythm of the heart, causing arrhythmias (irregular heartbeats). Recently, scientists have established that cocaine binds directly to heart muscle cells, slowing the passage of sodium ions into the cells. Cocaine also causes the release of the neurotransmitter nor epinephrine (nor adrenaline), a chemical messenger that stimulates the autonomic nervous system. Both changes can lead to arrhythmias. Heart attacks in young people are rare. However, when they do occur, cocaine is frequently the cause.

Cocaine is a highly addictive substance, and crack cocaine is substantially more addicting, as the drug is far more potent and is smoked. Users quickly develop a tolerance to crack cocaine, needing more of the substance to achieve the desired effects. Because the high from crack cocaine is so short-lived, users commonly smoke it repeatedly in order to sustain the high. This can lead to an even faster onset of addiction. Also, because crack cocaine works on the brain’s system of reward and punishment, withdrawal symptoms occur when the drug’s effects wear off. These symptoms can include depression, irritability, and extreme fatigue, anxiety, an intense craving for the drug, and sometimes even psychosis. Users will often keep using crack cocaine simply to avoid the negative effects of withdrawal

Marijuana harms in many ways, and kids are the most vulnerable to its damaging effects. Use of the drug can lead to significant health, safety, social, and learning or behavioural problems, especially for young users. Making matters worse is the fact that the marijuana available today is more potent than ever. Short term effects of marijuana use include memory loss, distorted perception, trouble with thinking and problem solving, and anxiety. Students who use marijuana may find it hard to learn, thus jeopardizing their ability to achieve their full potential. Long term effects include reduced resistance to common illnesses (colds, bronchitis, etc.), suppression of the immune system, growth disorders, increase of abnormally structured cells in the body, reduction of male sex hormones, rapid destruction of lung fibre’s and lesions (injuries) to the brain could be permanent, Study difficulties: reduced ability to learn and retain information, apathy, drowsiness, lack of motivation, personality and mood changes, inability to understand things clearly.

ACADEMIC EFFECTS OF ALCOHOL, TOBACCO AND DIFFERENT DRUG USE Heavy drinking by students can lead to positive blood alcohol levels the next day, affecting whether or not they even get up for class and, if they do, the quality of how information is processed and ultimately stored. Sleeping off a buzz, a common practice, can interfere with the sleep cycle, resulting in an increase in anxiety, jumpiness, and irritability the next day, and fatigue the day after that With evening use, marijuana has the same impact on sleep that alcohol has, throwing off the sleep cycle and impacting how a person feels for at least two additional days. Marijuana suppresses neuronal activity in the hippocampus, resulting in problems with attention, memory, and concentration. There is increasing evidence that there is an impact to motivation following marijuana use. This could be due to the effect of THC in the body blocking the passage of nutrients through cells, the neuronal suppression in the hippocampus, or the decrease in energy accompanying the fatigue that follows night time use. Marijuana significantly increases heart rate, weakens the heart muscle, and affects blood pressure- the increase in heart rate can be a concern for someone already dealing with anxiety ( and particularly panic). College students often forget why they are supposed to be in school. Is the purpose of university life to party all the time or to get the most out of the learning environment? Substance abuse can seriously affect academic performance. Aside from long-term addiction (or possible emptying you bank account) it can cause grades to plummet. How? Substance use affects you entire body, including your brain, in a variety of ways. Judgment is often the first attribute to be affected. You may find it difficult to make good decisions, to make them quickly or to be realistic when you make them. Suddenly, it becomes much easier to wait until the last minute to cram for that exam or to crank.

First of all, drugs and alcohol are a drain on people’s finances. We have all experienced the stress associated with money at one time or another. For those who abuse drugs or alcohol, financial issues are further compounded by their need to feed their habit. They frequently accumulate debt, borrow or steal money from others, or choose their substance of choice over more important things like food for their family or utility bills. While no one wants to be homeless, in debt, or engaging in criminal activities, the financial impact of drug and alcohol abuse risks not only your ability to support yourself, but it can also destroy relationships. When you abuse drugs or alcohol, you are choosing that substance over everything else, including your loved ones. Whether they are suffering from your financial choices or have become mistrustful of you, you have placed a strain on your relationships, which can ultimately ruin those connections for good. Families and others that rely on a sufferer of alcoholism are likely to experience problems related to financial troubles caused by drinking habits. The costs of alcohol increase as the alcoholic person builds tolerance to the drug in his or her system. This requires the person to take in ever-greater amounts of alcohol in order to feel the same effects. The psychological effects of this alcohol tolerance and dependency may cause the sufferer to become withdrawn and less supportive of colleagues, friends and family members. Sufferers may no longer attend social functions that do not allow drinking and may not be fully aware of their behaviour if attending functions where their drug of choice is allowed. A lack of networking and communication with peers may cause further financial problems if the sufferer loses promotion opportunities. Greater drains on income and lessened opportunities may cause undue troubles for others financially dependent on the sufferer, requiring a spouse or roommate to pick up extra hours or a second job to keep bills at a manageable level.

SOCIAL EFFECTS OF ALCOHOL, TOBACCO AND DIFFERENT DRUG USE Excessive alcohol use can affect all areas of a person’s life, including family, work and personal relationships. Family problems: Arguments over someone’s drinking can cause family and relationship problems that may lead to break up. Work problems: Drinking alcohol at work and hangovers can lead to poor performance and accidents at work, while illness can result in absenteeism. Legal problems: Drink-driving may lead to fines, loss of license and even imprisonment Misbehaviour caused by alcohol can also have disastrous effects on a pupil’s educational attainment, as well on performance in tests of intellect in later life. Compared with those pupils who have never truanted, pupils who had ever truanted from school had increased odds of having drunk alcohol in the last week (odds ratios of 2.24 for those who had truanted in the last year, 1.69 who had truanted previously). 6.5% of permanent exclusions of children from English state-funded secondary schools in 2010/11 were due to alcohol. Women, especially young women, encounter special risks in groups of drinking friends and acquaintances. In many societies, a woman who drinks seems to signal that she is at least approachable, and to some men an intoxicated woman is by definition sexually available. Such concepts as ‘acquaintance rape’ and ‘date rape’ bear witness to recent concern with this problem. A large proportion of unwanted sexual advances are mediated by alcohol. Initiation into certain groups, such as military units or college fraternities, sometimes includes drinking very large amounts of alcohol, so-called ‘binge drinking’. This pattern of drinking entails high risks of accidental injury, violence and acute alcohol-poisoning. It has long been known that a heavy-drinking lifestyle in groups of friends is relatively common in the armed forces. More recently, the focus has been on such drinking patterns on college and university campuses and what they mean for the development of problem drinking patterns later in life. INTERVENTIONS

A drug intervention is a structured, solution-oriented process undertaken to persuade someone who is abusing drugs to seek help in overcoming the addiction. Family, friends, and others involved in the person’s life use the intervention to demonstrate the extent of the effects of drinking and related behaviours. A successful intervention is not a confrontation but an opportunity for an addicted individual to accept help in taking the first step toward recovery. Often, an interventionist is invited to serve as a guide and educator before, during, and after the intervention. Some drug addicts can and do recognize the extent of the problems stemming from drug abuse and seek treatment without the need for an intervention. Most, however, are reluctant or unable to realize that drugs are responsible for the problems in their relationships, health, or work. They ignore the safety issues related to drinking and driving and other high-risk behaviours. It is common for addicts to deny that drugs are the source of the difficulties they face. They may instead blame other people or circumstances in their lives. When that happens, an intervention can break through the denial and help these individuals clearly see the effects of their drug abuse on the people who matter most to them.

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Alcohol, Aggression, and Violence: From Public Health to Neuroscience

Kajol v. sontate.

1 National Forensic Sciences University, Gandhinagar, India

Mohammad Rahim Kamaluddin

2 Centre for Research in Psychology and Human Well-Being, Faculty of Social Sciences and Humanities, Universiti Kebangsaan Malaysia, Bangi, Malaysia

Isa Naina Mohamed

3 Department of Pharmacology, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia

Rashidi Mohamed Pakri Mohamed

4 Department of Family Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia

Mohd. Farooq Shaikh

5 Neuropharmacology Research Laboratory, Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Subang Jaya, Malaysia

Haziq Kamal

6 Department of Physiology, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia

Alcohol has been associated with violent crimes and domestic violence across many nations. Various etiological factors were linked to chronic alcohol use and violence including psychiatric comorbidities of perpetrators such as personality disorders, mood disorders, and intermittent explosive disorders. Aggression is the precursor of violence and individuals prone to aggressive behaviors are more likely to commit impulsive violent crimes, especially under the influence of alcohol. Findings from brain studies indicate long-term alcohol consumption induced morphological changes in brain regions involved in self-control, decision-making, and emotional processing. In line with this, the inherent dopaminergic and serotonergic anomalies seen in aggressive individuals increase their susceptibility to commit violent crimes when alcohol present in their system. In relation to this, this article intends to investigate the influence of alcohol on aggression with sociopsychological and neuroscientific perspectives by looking into comorbidity of personality or mood disorders, state of the mind during alcohol consumption, types of beverages, environmental trigger, neurochemical changes, and gender differences that influence individual responses to alcohol intake and susceptibility to intoxicated aggression.

Introduction

Alcohol use disorder (AUD) is one of the leading causes of the global burden of disease and injury (WHO), despite the continuous discovery of novel pharmacotherapeutic agents (Pakri Mohamed et al., 2018 ). Various factors such as environmental, social, situational, and cultural context have distinctive consequences toward substance use and its effects on individuals (Latkin et al., 2017 ). Alcohol alters the mental state of individuals, including emotional processing and rational thinking, making the users unpredictable and dangerous, especially young people (Australian Government, 2017 ) or those with pre-existing psychological or psychiatric comorbidities (Brem et al., 2018 ; Puhalla et al., 2020 ). Violence related to substance use has been widely reported and studied, particularly the potential for violent outcomes between the different substances of use (Duke et al., 2018 ). Studies from various countries have reported crimes and domestic violence owing to alcohol (Hagelstam and Häkkänen, 2006 ; Mayshak et al., 2020 ), especially during the recent state of global coronavirus disease 2019 (COVID-19) pandemic (Finlay and Gilmore, 2020 ).

Alcohol and Domestic Abuse/Violence

There is a strong evidence linking alcohol with domestic abuse or domestic violence (Gadd et al., 2019 ). A study conducted within the metropolitan area of Melbourne, Australia found that alcohol outlet density was significantly associated with domestic violence rates over time (Livingston, 2011 ). In Australia, alcohol-related domestic violence is twice more likely to involve physical violence including life-threatening injuries (Mayshak et al., 2020 ). In the UK police report audit, approximately two-thirds of domestic incidents reported to police involve “under the influence of alcohol” (Alcohol Research UK). The same study also noted more aggression if alcohol was involved and persons involved considered alcohol to have a direct effect on their behavior. International evidence reveals a similar pattern with men tend to cause worse assaults after drinking and women are more likely to suffer from abuse with living partners who are heavy drinkers (Reno et al., 2010 ; Graham et al., 2011 ). These behavioral patterns cannot be inferred from women. Studies have demonstrated that women who are heavy alcohol drinkers tend to suffer from abuse themselves and also suffer from higher aggression from their partners (Hutchison, 1999 ; Iverson et al., 2013 ). In India, those who had a heavy drinker in their lives (family, relative, neighbor, etc.) reported having been harmed by them through physical, sexual, psychological, financial, and social. In Kerala, India, a cross-sectional study involving spouses of alcohol-dependent males undergoing a deaddiction program reported a high correlation between domestic violence and years of marriage and the number of stressful events in the past year (Indu et al., 2018 ). In the USA, 40% of the reported domestic violence has the alcohol factor present during the time of the offense (Galbicsek, 2020 ). It is also found that the intensity of violence is greater when the offender is intoxicated compared to when he/she is not. Based on existing literature, alcohol consumption is more related to the severity of domestic violence rather than its occurrence (Graham et al., 2011 ) and exacerbated by an increase in consumption (Ferrari et al., 2016 ). Although there is a clear correlation between alcohol and domestic abuse, these correlations are limited to men and, therefore, form a complex relationship, hence establishing a unidirectional relationship between domestic violence and alcohol is not possible at present (De Paula Gebara et al., 2015 ). As per UN Women of the United Nations, the global prevalence of domestic violence against women was 1 in 3 prior to COVID-19 pandemic, mainly perpetrated by their intimate partners. Emerging data from a number of countries show an increase in calls to domestic violence helplines since the beginning of COVID-19 pandemic. The United Nations Secretary-General has referred to this surge in domestic violence amid COVID-19 pandemic as a “shadow pandemic” (Women UN, 2020 ). Several countries showed a shockingly increasing pattern of domestic violence cases globally, up to 50% in Brazil, 20% rise in helpline calls in Spain, 30% in Cyprus (The Guardian, 2020 ), 25% increase in helpline calls and about 150% rise in Refuge website in the UK (Bradbury-Jones and Isham, 2020 ), and almost doubled cases of domestic violence in the Hubei, China (Anju, 2019 ). COVID-19 pandemic-induced increase in global domestic violence was irrespective of the economic status of the countries (Finlay and Gilmore, 2020 ). In line with this, the alcohol sales in March 2020 were increased by 67% in the UK during lockdown (Finlay and Gilmore, 2020 ). Contrary to this, a recent systematic review revealed that there is insufficient evidence to suggest that COVID-19 pandemic has led to increased substance use and domestic violence (Abdo et al., 2020 ) ( Table 1 ).

Alcohol and domestic violence.

Alcohol, Aggression, and Violence: Psychiatric Comorbidities

There were various publications related to the etiological factors associating alcohol use and violence. Study has shown that alcohol was most commonly abused among adolescents and school children (Bland et al., 2018 ). Factors such as developmental milestones when a child is growing up can predict violence and substance abuse in adults (Hentges et al., 2018 ; Malti, 2020 ). Retrospectively, heavy drinking in later life can be predicted by early childhood aggression (Gottfried and Christopher, 2017 ). A combination of substance use and psychiatric disorders is associated with an above-average risk of adult violent behavior (Wiener et al., 2018 ). Mental disorders such as anxiety and mood disorders have also been commonly associated with AUD (Gimeno et al., 2017 ). AUD and depressive symptoms are commonly reported with other mood disorders and have greater severity and worse prognosis compared when it is concomitant with AUD (Higley and Linnoila, 2002 ). There are possibilities of the symptoms exhibited by the patients during withdrawal or acute intoxication that are pre-existing effective disorders or in a combination (Serafini et al., 2017 ). The most common symptoms of substance withdrawal include agitation. Other symptoms such as disinhibition and despair are commonly associated with substance abuse disorder that would be amplified into self-destructive acts and impulsivity (Goldstein et al., 2017 ; Duica et al., 2020 ). In addition, men with antisocial traits are at greater risk of binge alcohol consumption and commit intimate partner violence (Brem et al., 2018 ). In US, the prevalence of antisocial personality disorder and adulthood antisocial behavioral syndrome was 4.3 and 20%, respectively, and both the syndromes were significantly associated with 12-month and lifetime substance use (Goldstein et al., 2017 ). Based on a study conducted in Italy that had a population of 717 make subjects−404 alcoholics and 282 having a personality disorder, alcohol consumption was higher among those who suffer from psychiatric conditions, especially personality disorder (39%; antisocial personality disorder at the most) and 14.2% have a dual diagnosis (personality disorder and alcohol dependence). The antisocial personality population (more than any other personality disorder) had an early onset of alcohol abuse and its association with physical dependence and legal problems (Poldrugo, 1998 ). Similar studies were conducted in the prisons of North Italy, which also suggested that there is a positive correlation between AUD and personality disorders and the risk of engaging in criminal acts is higher within the individuals with dual diagnosis (alcoholics and sociopaths). Intermittent explosive disorder (IED), characterized by repeated, sudden explosive outbursts of anger or violence, has been associated with a history of childhood abuse and AUD is at a greater risk for intoxicated aggression (Puhalla et al., 2020 ) and also to develop substance use disorder compared to those without IED (Coccaro et al., 2017 ).

Alcohol, Aggression, and Crime

Aggression is the basic ingredient of acts of violence (Eisner and Malti, 2015 ). Violence as aggression has the goal of extreme harm including death. In this context, violent and criminal behavior is often associated with substance abuse (Anderson and Bushman, 2002 ). Alcohol is one of the major ingredients of violent incidents (i.e., murder) due to its disinhibiting effects along with loss of emotional control that increases the susceptibility to physical assaults and eventually murder (Karlsson, 1998 ). According to Mokdad et al. ( 2004 ) and Pinel and Barnes ( 2018 ), alcohol is involved in more than 2 million deaths (deaths due to ill health, accidents, and violence) each year across the world. A moderate dose of alcohol in the blood tends to cause cognitive, perceptual, verbal, and motor impairments as well as a loss of control, which eventually lead to unacceptable social behavior including violence (Pinel and Barnes, 2018 ). From a criminological perspective, alcohol is an important factor in violent interactions that culminate in murder (Wahlsten et al., 2007 ). Substance abuse, especially alcohol, is widely acknowledged as an important risk marker for criminal behavior and violent crimes including those with mental disorders (Brennan et al., 2000 ; Wallace et al., 2004 ; Erkiran et al., 2006 ). The strong link between alcohol use and violence is well-demonstrated (Mann et al., 2006 ), as alcohol consumption is an important factor for the prevalence of violence (Room and Rossow, 2001 ).

Alcohol facilitates conflicts with others and increases the potential for violent behavior among the drinkers and others (Wieczorek et al., 1990 ; Mann et al., 2006 ; Wahlsten et al., 2007 ). Expressive murders are most often preceded by arguments and altercations and the level of intoxication increases the viciousness of the attack (Karlsson, 1998 ). Block and Block ( 1992 ) defined expressive murders as a result of the expression, emotions, and psychological states. Emotional states such as anger, frustration, and hostility are said to lead an individual to perform expressive murders. In this context, alcohol is said to be the credible factor leading to emotional loss and instability and eventually leading to expressive-based murders. A national study of 16,698 inmates found that alcohol had a stronger role in violent offending such as homicide, physical assaults, and sexual assaults compared to offenses such as burglary and robbery. In this study, the majority of the respondents claimed to have been under the influence/intoxication of substance(s) such as alcohol during the commission of murder (Felson and Staff, 2010 ).

In 2011, 73 and 57% of the homicides recorded in the United States and Russia were alcohol related (Landberg and Norström, 2011 ), whereas, in countries including Finland, Netherlands, and Sweden, alcohol consumption led to lethal violent crimes reported from 2003 to 2006. In Finland alone, 491 persons were killed within 4 years period and ~82% of the perpetrators were intoxicated with alcohol, where 39% of them were alcoholics and 45% of the reported murders were committed with knives (Liem et al., 2013 ). In Singapore, out of 253 homicide offenders, 141 individuals (56%) were suffering from AUD and 121 offenders (48%) drank alcohol within 24 h preceding their criminal offense (Yeo et al., 2019 ). In the Brazilian city of Diadem, limiting the hours of alcoholic sales in bars to 11 p.m. significantly declined the crime rate to 9 homicides per month (Duailibi et al., 2007 ). Chervyakov et al. ( 2002 ) reported that 4 in every 5 Russians convicted of murder were intoxicated with alcohol during the murderous act. In a British prison sample, over a third of male homicide offenders had consumed alcohol and were considered drunk at the time of the offense and 14.0% had been using drugs (Dobash and Dobash, 2011 ).

Even though many findings from various countries strongly concluded that alcohol is a risk factor for murderous acts, however, most of these studies correlated level of alcohol consumption rather than the pattern of hazardous intake or types of beverages consumed, which is more likely to cause severe disinhibition, hence more damages. In line with this, using a sample of 85 countries, Weiss et al. ( 2018 ) reported no association between alcohol consumption level and homicide rates; however, they found a positive association between hazardous drinking pattern and homicide rates. Contrary to this, a cross-sectional analysis of data from 83 countries that controlled for several possible covariates reported that countries with riskier drinking patterns did not have higher homicide rates compared to countries with less risky drinking patterns. However, the same investigators also reported that the association between homicide rates and alcohol was beverage specific, with beer and spirit consumption were positively correlated with homicide rates and wine negatively correlated with the rate of homicides (Hockin et al., 2018 ) ( Table 2 ).

Alcohol and homicide rates.

Alcohol and Aggression: A Neuroscience Perspective

Alcohol accentuates or promotes the mental state of the drinkers at the time of consumption, fueling negative emotions such as aggressive behavior or positive emotional outcomes such as gregariousness and warmth. Aggression is classified as impulsive, premeditated, and medically driven (Gollan et al., 2005 ). Even cognitively intact alcohol-dependent individuals showed higher psychopathological symptoms with trait impulsivity (Kovács et al., 2020 ) and other psychiatric comorbidities such as antisocial and borderline personalities (Helle et al., 2019 ) triggering medically driven aggression. Unlike impulse-driven aggression, which is reflective of an agitated state of mind, premeditated aggression is a planned aggressive act (Martin et al., 2019 ).

The aggressive acts at some points could be goal oriented, whereas in some instances could be impulse driven. Impulsivity is defined as fast actions taken without adequate or with little thought and conscious judgment of the consequences (Bakhshani, 2014 ). Assessment of various brain regions of 1,200 men and women of 18–35 years old along with their tendency to make rapid decisions seek for novel and intense experiences and risk-taking traits revealed a significant decrease in the cortical thickness of brain regions related to self-control and decision-making processes, particularly anterior cingulate and middle frontal gyrus (Holmes et al., 2016 ). Alcohol itself directly interrupts the executive cognitive functions by disrupting the functions of the prefrontal cortex (PFC), which has been associated with disinhibition and aggression (Heinrichs, 1989 ). The PFC, which regulates aggressive and social behavior (Davidson et al., 2000 ; Seo et al., 2008 ), was shown to be reduced in its volume in individuals with antisocial personality disorder (Raine et al., 2000 ). In addition, neuroimaging of individuals with IED revealed lower white matter integrity in long-range connections between the frontal and temporoparietal regions (Lee et al., 2016 ), reduced gray matter volume in the frontolimbic structures (Coccaro et al., 2016 ), and gray matter deficit and dysfunction of the left insula (Seok and Cheong, 2020 ). The orbitomedial region within the PFC regulates anger and impulsive aggression (Lapierre et al., 1995 ; Davidson et al., 2000 ) and assigns appropriate emotion to the consequences of actions (Bechara et al., 2000 ). During aggressive behaviors, reduced activity was reported within the orbitofrontal PFC (Goyer et al., 1994 ; Pietrini et al., 2000 ), where the impaired PFC is unable to inhibit the subcortical structures such as the amygdala, hippocampus, and nucleus accumbens from activating emotional output (Raine et al., 1998 ; Davidson et al., 2000 ). In line with this, an increase in amygdala limbic connectivity and a significant decrease in amygdala-medial PFC connectivity were reported among violent offenders (Siep et al., 2019 ). Hyperactivation of the amygdala is also reported in individuals with IED in response to angry faces compared to controls (McCloskey et al., 2016 ). Moreover, alcohol-dependent patients with a history of aggressive behavior also recorded elevated glutamate/creatine ratio in the bilateral amygdala (Liu et al., 2020 ) corroborating various other behavioral changes associated with glutamatergic hyperexcitability state in the amygdala reported in past studies (Kumar et al., 2013 , 2016 , 2018 ; Pakri Mohamed et al., 2018 ; Kamal et al., 2020 ).

Serotonin in AUD and Aggression

Aggression is a complex behavior involving interactions between the gene, environment, personality, and physiology (Armstrong et al., 2017 ; Zhang et al., 2017 ; Kanen et al., 2021 ). Dysregulation of serotonin is associated with many psychiatric disorders (Rappek et al., 2018 ; Conio et al., 2020 ; Fanning et al., 2020 ) due to the widespread distribution of serotonergic fibers originating from midbrain raphe nuclei to various other regions (Sharp and Barnes, 2020 ). Based on a systematic review, the association between serotonin and aggression is rather mixed, where reduced 5-hydroxytryptamine (5-HT) concentration in central nervous system (CNS) was associated with reactive aggression (impulsivity; response to provocation), whereas increased 5-HT (small number of findings) may be related to callous-unemotional traits, which is another possible pathway to aggressive behavior (Runions et al., 2019 ). In line with this, SLC6A4 * HTTLPR or 5-HTTLPR (serotonin transporter) was associated with aggression within the population of Pakistan (Qadeer et al., 2021 ), China (Zhang et al., 2017 ), and the United States of America (Armstrong et al., 2017 ), whereas, in a study conducted among Russian inmates, such correlation was not found (Toshchakova et al., 2017 ). Furthermore, other genes of serotonin such as 5-hydroxytryptamine receptor 2A (5HTR2A), 5-hydroxytryptamine receptor 2B (5HTR2B), and 5-hydroxytryptamine receptor 2C (5HTR2C) also showed no association with aggressive behavior (Toshchakova et al., 2017 ; Qadeer et al., 2021 ), suggesting a stronger link between brain serotonin level and aggression rather than the receptors, which was also proven by studies using selective serotonin reuptake inhibitors (SSRIs) (Nord et al., 2013 ; Lagerberg et al., 2020 ). Likewise, a lower cerebrospinal level of 5-hydroxyindoleacetic acid (5-HIAA), the main metabolite of serotonin, was reported in the impulsive offenders than the premeditated murderers (Linnoila et al., 1983 ). Regions such as the cingulate cortex, ventromedial, and the orbitofrontal PFC were shown to have reduced serotonergic activity during impulsive aggression (Siever et al., 1999 ). Similar findings also reproduced in non-human animal models (Harrison et al., 1997 ; Kästner et al., 2019 ; Gorlova et al., 2020 ).

Some researchers have reported high serotonin transporter (SERT) bindings in the brains of deceased alcoholics (Underwood et al., 2018 ), whereas others have reported low binding (Mantere et al., 2002 ) and some reported no differences (Brown et al., 2007 ; Martinez et al., 2009 ). Similarly, mixed findings were also reported for 5-HT1A and 5-HT2A receptor bindings (Underwood et al., 2008 , 2018 ; Storvik et al., 2009 ). Chronic alcohol intake increases the metabolites of serotonin in the raphe nuclei area, however reduces 5-HT2A protein levels in the mice cortex, indicating reduced serotonergic activity (Popova et al., 2020 ). Acute alcohol intake reduces tryptophan availability to the brain (non-aggressive), which leads to a decrease in serotonin synthesis and turnover, about 25% of the concentration of tryptophan following an oral intake of alcohol (Badawy et al., 1995 ). Hence, it is probable that in the aggressive brain, the drop in brain serotonin synthesis might even be greater (40–60%) during moderate intake of alcohol (Badawy, 2003 ). However, the inconsistent findings of serotonin markers in brain imaging studies of alcoholics suggest that comorbidity of AUD with other psychiatric disorders may complicate the serotonin hypothesis in real life. In addition, even individual differences in personality traits determine the types of emotion affected by the depletion of serotonin (Kanen et al., 2021 ).

Dopamine in AUD And Aggression

Serotonin and dopamine levels are significant predictors of aggression and suicide risk (Prepelita et al., 2019 ). A systematic review of pre-clinical findings suggests that adolescence chronic stress may lead to a hyperdopaminergic state of the PFC, which eventually blunts the adulthood prefrontal dopaminergic neurotransmission, increasing the vulnerability to maladaptive aggression in adulthood (Tielbeek et al., 2018 ). In relation to this, polymorphisms of catecholamine-converting enzymes such as monoamine oxidase and catechol-o-methyltransferase along with traumatic childhood significantly increase appetitive and Facilitative Aggression Scale (Fritz et al., 2021 ). Furthermore, a study conducted on convicted Pakistani murderers revealed a high prevalence of the 9R allele of DAT-1VNTR, which influences the intrasynaptic dopamine levels (Qadeer et al., 2017 ). Pharmacological modulation of dopamine D2 receptor via its antagonist, sulpiride, impaired the ability to discern angry facial expressions in humans (Lawrence et al., 2002 ). However, some researchers have reported the opposite, where polymorphism in DRD2 genotypes causes reduced dopamine functioning that is directly associated with increased aggression (Zai et al., 2012 ) which may occur through sensation seeking (Chester et al., 2016 ). Nevertheless, it was hypothesized that impaired serotonin neuromodulatory effects may lead to dopamine hyperactivity in subcortical structures and aggressive behaviors (Seo et al., 2008 ). Studies investigating the interaction between genetic polymorphism of dopamine system (dopamine receptors; DRD2, DRD4, transporter; DAT1), and environmental factors (financial stressor and adolescent social experiences) on intimate partner violence revealed a strong influence of negative environmental changes on increased odds of violence perpetration regardless of the alleles (Schwab-Reese et al., 2020 ).

In addition to aggression, alcohol alone modulates dopaminergic neurotransmission, where even the cues of alcohol could increase the dopamine release in the nucleus accumbens (Melendez et al., 2002 ). Dysregulation of dopaminergic neurotransmission in AUD has been demonstrated in several brain imaging studies (Leurquin-Sterk et al., 2018 ; Chukwueke et al., 2021 ). Factors such as personality traits and comorbidities with other psychiatric disorders along with environmental stressors influence how one could engage in violent behaviors. Hence, even though alcohol might be the precursor to violence for some, it certainly takes more than the beverage to increase the likelihood of someone shooting from the hip.

Alcohol, Aggression, and Violence: A Conundrum

Individual reports from multiple countries have associated alcohol with violent crimes and domestic abuse. Consumption of alcoholic beverages with higher alcohol content at a dose of 0.75 g/kg and higher was correlated with increased aggression (Hockin et al., 2018 ; Kuypers et al., 2020 ), whereas a comprehensive review found no association between homicide rates and alcohol consumption level (Weiss et al., 2018 ). Even countries with a riskier drinking pattern did not show a higher crime rate compared to countries with less risky drinking patterns (Hockin et al., 2018 ). This led us to the question, does alcohol alone is sufficient to trigger violent or aggressive behavior? Based on the pieces of literature gathered in this article and past findings, it is evident that several individual and environmental factors determine the likelihood of an intoxicated person engaging in an aggressive or violent act. Emotional dysregulation and impulsivity in combination with pre-existing psychiatric comorbidities such as personality disorders, intermittent explosive disorder along with genetic pre-disposition and environmental stressors, such as the most commonly associated childhood adversity, are one of the triggers of intoxicated aggression. Genetic polymorphism findings indicate that environmental stressors play a more significant role in perpetration violence compared to high-risk genotypes (Schwab-Reese et al., 2020 ). However, some have reported that epigenetic mechanisms mediate the interaction between genetic and environmental factors by altering genes of many systems including the nervous, immune, and neuroendocrine (Chistiakov and Chekhonin, 2017 ).

Stress during early life, also known as childhood adversity or childhood maltreatment, is associated with the development of personality disorders (Lemgruber and Juruena, 2013 ; Porter et al., 2020 ), affective disorders (Hoppen and Chalder, 2018 ), and alcohol use disorder (Evans et al., 2017 ). Among these, physical, emotional abuse, and maternal rejection are associated with the shaping of personality (Schouw et al., 2020 ) and maladaptive schemes in adulthood (Pilkington et al., 2021 ). For an instance, physical abuse and neglect lead to antisocial traits (Schorr et al., 2020 ). Factors such as family dysfunction, as violence in the family, show a strong correlation with adulthood aggression (Khodabandeh et al., 2018 ; Labella and Masten, 2018 ) through emotion-related impulsivity and behavioral response inhibition (Madole et al., 2020 ). In line with this, it has been reported that a high level of childhood adversity increases one's likelihood to substance use through reduced functioning of the anterior cingulate cortex in inhibitory control, indicating a higher impulsive response (Fava et al., 2019 ). The very nature of adversity (threat vs. deprivation) has a distinctive effect on emotional circuits. For an instance, childhood threat was reported to reduce the volume of the medial PFC, amygdala, and hippocampus along with increased activation of the amygdala in response to a threat, whereas childhood deprivation alters the function and volume of the frontoparietal regions, which are associated with goal oriented and executive functions (McLaughlin et al., 2019 ). In addition to the type of adversities, individual differences in threat and executive control-related brain regions also determine how one with childhood adversity would express adult trait anger. Individuals with the low amygdala and high dorsolateral PFC activity do not express high trait anger, despite having experienced stress in early life (Kim et al., 2018 ). Suppression of adult trait anger was owing to the higher microstructural integrity of white matter pathways, including the uncinate fasciculus, which anatomically links the PFC and amygdala in the regulation of negative emotion (Kim et al., 2019 ). However, the findings by Kim et al. ( 2019 ) were based on subjects free of borderline and personality disorders, which are the most commonly associated psychiatric comorbidities with intoxicated aggression and also known to have reduced white matter integrity in regions associated with risky behavior and impulsivity (Jiang et al., 2017 ; Ninomiya et al., 2018 ). Hence, more longitudinal studies are needed in the future to understand the effects of early life stress on the development of aggression-related psychiatric comorbidities from neurological perspectives. Furthermore, the role of white matter integrity in one's expression of anger despite the chronic stress in early life should be further explored to understand the cause behind such discrepancy and the consistent neurological changes noticed in conjunction with high-risk behaviors could be investigated as potential biomarkers to predict one's risk factor along with social experiences ( Figure 1 ).

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Childhood adversity affects the shaping of personality, which eventually leads to development of personality disorder, alcohol use disorder, substance use disorder, intermittent explosive disorder (IED), and aggressive behaviors such as domestic abuse or expressive murders in adulthood. Factors such as genetics and environment also interact with alcohol intake and causing neuroplasticity in brain regions associated with emotional and cognitive regulation. Childhood stress such as deprivation alters the function and reduces the volume of frontoparietal regions that associated with goal-oriented and executive functions. Childhood adversity including threat reduces the volume of the medial prefrontal cortex (MPFC), amygdala (AMG), and hippocampus (HPC). Chronic early life stress also blunts the dopaminergic activity in the PFC. Alcohol disrupts the serotonergic activity in the PFC. Altered functions of the orbitofrontal cortex (OFC) unable to inhibit the increased emotional output from subcortical structures such as the hyperactivation of AMG in IED. Reduced connectivity between MPFC and AMG was reported in violent offenders. Adults having experienced childhood adversity and do not express high adult trait anger were due to higher white matter integrity in pathways connecting the PFC and AMG.

Gender Differences in Binge Drinking, Alcohol-Induced Aggression, and Violence

It was initially reported that women are less likely to engage in binge drinking patterns than men (Bobrova et al., 2010 ). However, in the recent years, data from the United States indicate that the binge-drinking rate in adult women (age 21–49 years) has been rising (Hasin et al., 2019 ; Sarah and Keyes, 2020 ). Evidence suggests that there is a little convergence in the pattern of binge drinking in men and women. It was found that the prevalence was higher for females than males from 2000 to 2010 for any binge drinking in the preceding month. On the contrary, the reason for the convergence of frequency in the male and female binge drinking habits is estimated to occur due to the large decline in the binge drinking frequency within men than the women. Furthermore, evidence also shows that the convergence of men and women has usually been stronger in the age group of young adults in comparison to any other age group (Wilsnack et al., 2018 ). Data from 2006 to 2018 indicate that both the men and women increasingly binge drink; in women, the largest increase was found in the age group 30–44 years without children (Sarah and Keyes, 2019 ).

Several studies have investigated the risk factors pertaining to intimate partner violence (IPV)/domestic violence (DV) and found that gender-specific differences exist in DV. The likelihood of females being victimized is greater than the male victimization, whereas evidence for the males being the perpetrators is higher than that of the females. The risk factors that are found to be common in both the men and women reporting perpetration involved being exposed to parental violence and physical abuse during childhood and alcohol abuse. Risk factors that are thought to be associated with male perpetration include unemployment, lower income, cohabitation, mood disorders, and no or lower level of education (Gass et al., 2011 ; Lee et al., 2014 ). Lack of education is thought to play a role in both the perpetration and victimization of women (Capaldi et al., 2012 ). Moreover, factors such as pregnancy, young age, higher income than the partner, and previous relationships increase the risk of victimization for women (Capaldi et al., 2012 ).

Prior reports have established alcohol-induced aggression among males (Lipsey et al., 1997 ), which appears to vary across the ethnic groups and geographical regions (Caetano et al., 2001 ). Systematic comparison between males and females in relation to alcohol-induced aggression revealed greater effects of alcohol on males than females (Ito et al., 1996 ; Bushman, 2002 ); however, the analysis was limited by insufficient power to detect significant effects due to limited female data. In agreement with this, a separate study reported a small-to-moderate effect size for the association between alcohol use and male-to-female partner violence, whereas a small effect size for the association between alcohol intake and female-to-male partner violence (Foran and O'Leary, 2008 ). More recently, a significant, small effect size was reported for the association between alcohol intake and aggression in female subjects who consumed alcohol compared to those who did not drink, in response to a subsequent aggression paradigm (Crane et al., 2017 ).

Males are more likely to express aggression in a physical and/or direct form, whereas females are more likely to express it in an indirect form. It has also been reported that both the males and females are equally aggressive when verbal aggression is at play (Archer, 2004 ; Björkqvist, 2017 ). In an experiment conducted by Giancola and Zeichner ( 1995 ), 128 participants (64 males and 64 females) performed a task where they gave an electric shock to the fictional opponents, which included both the genders. The participants were assigned to either alcohol, a placebo, or a sober group. The researchers found that the intensity and duration of shock were higher in the men from the alcohol group, while only shock duration was increased in women. They also noted that men were highly aggressive toward the same gender, while women were aggressive regardless of gender. This indicated that alcohol-induced aggression affects both the genders in different ways, suggesting that men are likely to respond in a direct and indirect manner, whereas women exhibit aggression in an indirect manner. A slightly different finding to the previous study was seen in an investigation conducted by Hoaken and Pihl ( 2000 ). The researchers assigned the participants (54 males and 60 females) to compete in a competitive aggression paradigm in an intoxicated or sober state. The result was that the intoxicated men were more aggressive than the sober men; however, in the circumstances where the women were highly provoked, both the intoxicated and sober women displayed higher levels of aggression, which could resemble the men. This suggested that both the women and men can be equally aggressive and alcohol does not seem to play a prominent role in the gender biases in aggression.

Several brain imaging studies have examined the neurological changes in men and women during aggression either by including an equal number (almost) of male and female subjects or a single gender (against a control group) (Chester and DeWall, 2016 ; Emmerling et al., 2016 ; Denson et al., 2018 ). To date, very few studies have tested the gender difference hypothesis using both the male and female subjects. Generally, men have recorded higher activation of the amygdala (McRae et al., 2008 ) and the PFCs (Rahko et al., 2010 ) during emotional reactions. Investigation of sex differences in neural correlates of aggression using 22 male and 20 female subjects revealed differential brain activation patterns between both the genders in response to provocation. Aggressive men recorded higher activation of the left amygdala than aggressive women and a positive correlation with orbitofrontal cortex (OFC), rectal gyrus, and ACC activity, which was negatively correlated in women. The findings indicate that aggressive men are more inclined to automatic emotion regulation (attributed to OFC and rectal gyrus) in response to provocation compared to aggressive women (Repple et al., 2018 ). In a separate study involving 24 men and 11 women, alcohol alone had no effect on the amygdala and ventral striatum; however, their activities were positively correlated with aggression in response to provocation. Alcohol decreased their bold responses in the right PFC, thalamus, hippocampus, caudate, and putamen. Neither gender had any significant impact on the results (Gan et al., 2015 ). Contrary to this, a single administration of 0.5 per thousand alcohol was shown to reduce frontal interhemispheric connectivity in female participants, but not in male participants (Hoppenbrouwers et al., 2010 ). Intergender neurological and behavioral responses to alcohol are also influenced by ethanol metabolism (Arthur et al., 1984 ) and influences of hormones such as testosterone, cortisol, estradiol, progesterone, and oxytocin (Denson et al., 2018 ).

Alcohol intoxication-induced aggression is an interplay between gender, genetic, psychiatric comorbidities, blood alcohol level, and environmental factors. Risk factors associated with intoxicated aggression or aggression should be packaged into a scientific explanation to educate the public. Alcohol is a weak drug, which needs to be consumed in large amounts in order to cause intoxication. Hence, high-risk individuals should practice moderate drinking. Parental roles in shaping the personalities of children should be incorporated into the marriage course as one of the preventive measures. Future studies and policymakers should include more behavioral interventions in the high-risk adolescent groups.

Author Contributions

KS and JK contributed to the conceptual framework, design, and drafted the manuscript. MR, IN, RM, and MS searched references and critically revised the manuscript. HK prepared the figure and legend. All the authors critically reviewed content and approved the final version for publication of manuscript.

This study was funded by the Ministry of Higher Education Malaysia, FRGS/1/2020/SKK0/UKM/02/3.

Conflict of Interest

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Publisher's Note

All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article, or claim that may be made by its manufacturer, is not guaranteed or endorsed by the publisher.

Acknowledgments

The authors would like to thank the Ministry of Higher Education, Malaysia, and Faculty of Medicine, UKM.

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Man drinking from a bottle of alcohol, with more empty bottles in the foreground.

For people with mental illness, drugs and alcohol can be a key survival strategy. I’ve learned they shouldn’t have to ‘get clean’ to get treatment

Mental Health Social Worker and PhD Candidate, Staffordshire University

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Simon Bratt does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.

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A decade ago, while working in a women’s prison, I met a young woman whose story would leave an indelible mark on me. She had endured severe abuse at the hands of men, and I was initially concerned that, as a male social worker, my presence might rekindle her trauma. Yet, through careful and considered engagement, we were able to forge a relationship of trust.

Jenny* confided in me that heroin had become her refuge – the only respite that quieted the relentless storm of her thoughts. But her dependency had brought dire consequences: the removal of her children and her subsequent imprisonment for possession with intent to supply. Even so, Jenny told me that before she was imprisoned: “Heroin was the only thing that helped me to cope.”

While inside, she experienced regular flashbacks and profound anxiety. Her treatment regime included antipsychotic medication Seroquel and heroin replacement Subutex – but Jenny didn’t use them conventionally. “The only way they help is if I grind them together and snort them,” she explained. This method provided her a fleeting, euphoric respite from her psychological torment.

Across the world, we’re seeing unprecedented levels of mental illness at all ages, from children to the very old – with huge costs to families, communities and economies. In this series , we investigate what’s causing this crisis, and report on the latest research to improve people’s mental health at all stages of life.

It wasn’t Jenny’s drug revelation that struck me most profoundly, but the reaction of some of my prison colleagues. Her unconventional use of the medication was labelled substance abuse, leading to her being ostracised by the prison’s mental health service, which refused to work with her until she “sorted out” her drug issues.

Even though I had known Jenny for a year, it was only when she was about to be released from prison that I really understood how serious her situation was. I was shocked to see her breaking the prison’s rules on purpose because she didn’t want to leave. She started smoking in places she shouldn’t, damaged her own cell and areas everyone used, attacked another prisoner, which was not like her at all, and started using spice and hooch.

Jenny preferred staying in jail over facing life outside, but she was let out all the same. A week after her release, I received news that she had died from a heroin overdose.

My search for answers

Mental health problems are experienced by the majority of drug and alcohol users in community substance use treatment. Death by suicide is also common, with a history of alcohol or drug use being recorded in 54% of all suicides in people experiencing mental health problems. ( Public Health England guide , 2017.)

Jenny’s tragic story left me with many questions – what were the underlying causes of mental illness? What spurred the spiral into addiction? Why did individuals turn to substance use? – that, even after six years as a mental health social worker working in prisons and psychiatric hospitals, I had neither the knowledge nor experience to answer. Talking to colleagues did not resolve them, so I sought answers by returning to academia alongside my day job.

A postgraduate diploma helped me better understand the theories of mental health from neuroscientific, psychiatric and pharmacological perspectives. But above all, I realised that many of the people I was now encountering in my new role, working in a crisis home treatment team (a community-based team set up to support people experiencing severe mental health issues), would never get better. Rather, they would just keep coming back with a new crisis.

And for a large majority of them (around four in five), substances ranging from highly addictive narcotics to potent, mind-altering chemicals would be a key part of their daily lives in addition to, or as an alternative for, their prescribed psychiatric medication.

This article is part of Conversation Insights The Insights team generates long-form journalism derived from interdisciplinary research. The team is working with academics from different backgrounds who have been engaged in projects aimed at tackling societal and scientific challenges.

Roger was one of many people I met who relied on Spice , a synthetic cannabinoid designed to mimic the effects of naturally occurring THC . (In addition to consumption by smoking, there are increasing reports of synthetic cannabinoids being used in e-cigarettes or vapes .)

Nonetheless, Roger told me Spice was the “only thing that would help sort my head out”. And, after listening to a lecture from me about the dangers of these substances, he responded:

I know how much to take – I know when I’ve taken too much or not enough. I use it in doses now. Why would I stop if it’s the only thing that works?

It was clear that Roger knew much more about the effects of Spice than I did. Interactions like this ignited a desire in me for deeper knowledge – not from books or universities, but directly from people with co-existing mental health and addiction problems.

Perhaps surprisingly, in the UK we don’t know how many people are living in this combined state. Estimates have tended to focus only on people with severe mental health problems and problematic substance use. For example, a 2002 Department of Health guide suggested that 8-15% of its patients had a dual diagnosis – while acknowledging that it is difficult to assess exact levels of substance use, both in the general population and among those with mental health problems.

A decade earlier, US research had identified that for people with schizophrenia , substance use (non-prescribed drugs) was a significant problem relative to the general population. More recently, a 2023 global review of evidence identified that the prevalence of co-existing mental health and substance use among children and adolescents treated for psychiatric conditions ranged between 18.3% and 54%.

But what I found particularly interesting was an analysis of the writings of Thomas De Quincey from more than 200 years ago. In his 2009 article Lessons From an English Opium Eater: Thomas De Quincey Reconsidered , leading clinical academic, John Strang, highlighted that issues raised by De Quincey in 1821 remain causes for concern some two centuries later.

De Quincey was arguably the first person to document his own use of substances, in particular opium. His writing shows that he self-medicated to manage pain, including “excruciating rheumatic pains of the head and face”:

It was not for the purpose of creating pleasure, but of mitigating pain in the severest degree, that I first began to use opium as an article of daily diet … In an hour, oh Heavens! What an upheaving, from its lowest depths, of the inner spirit!

De Quincey’s use of non-prescribed drugs mirrors that of John, Jenny, Roger and so many other people I have met as a social worker. Clearly, we’ve known about the close relationship between mental illness and substance abuse for hundreds of years, yet are still wrestling with how best to respond.

Read more: Guide to the classics: Confessions of an English Opium Eater by Thomas De Quincey – a dense, strange journey through addiction

Official guidance almost always advocates for a “no wrong door” policy , meaning that those with dual addiction and mental health issues will get help whichever service encounters them first. But from what people with lived experience were telling me, this was not the case.

I sent freedom of information requests to 54 mental health trusts across England, to try to discern any patterns of variation in the way their patients were being measured and treated. Some 90% of the trusts responded, of which a majority (58%) recognised the dual occurrence of mental illness and substance use. However, the estimated prevalence of this dual diagnosis varied widely – from only nine to around 1,200 patients per trust.

What I found most alarming was that less than 30% of the mental health trusts said they have a specialised service for addiction which accepts referrals for dual diagnosis patients. In other words, throughout England, a lot of these patients are not being appropriately supported.

Out-of-focus man holding a syringe in the foreground

‘When I say I use heroin, people change’

I started using when I was around 18. Things weren’t good in my life at the time, and I got in with a crowd who offered me heroin. It was the most amazing experience; all my worries disappeared better than the antidepressants I had been taking. But the more I used, the more I needed it. Now I use it in stages, just before I go to work and at night.

Carl had been using heroin for more than ten years when I interviewed him. When I asked if he wanted to stop, he shrugged and said no, explaining:

I’ve tried so many times – I’ve been on methadone but that was worse, especially coming off it. I know how much to take, and no one knows I use gear – so, no. But, as soon as you tell a professional you take heroin, their whole attitude changes. I’ve seen it many times. I dress quite well and I have a job, but as soon as I say I use heroin, they change. It’s almost as if they don’t see the same person any more.

Talking to Carl underlined that many users know far more than me about the substances they take and why they take them. Yet as soon as a professional (typically a nurse, social worker or doctor) hears they are taking an illegal substance, or are misusing a legal substance such as alcohol, they are stigmatised and often ostracised from service provision.

Suzanne was homeless and also using heroin, but for different reasons to Carl. I asked why she started using it:

I’ve had a shit life – it numbs all of that. Now being homeless, it helps me to sleep and keeps me warm, but I only use it in the winter because I need to sleep.

In summer, Suzanne explained, she would switch to taking “phet” – amphetamines. I asked her why:

You need to be awake – there are lots of dickheads around. I’ve been beaten and raped in the summer when I was asleep, so you need to be awake more.

Hearing the stories of people fighting their personal battles with mental health and substance use issues was at once haunting and cathartic for me. It was deeply moving to hear them, time and again, struggling with the most difficult aspect of their condition: the simple decision to ask for help. And sadly, far too often, when they did summon the courage, their requests would go unheard, unheeded, or they would be engulfed by a sprawling system that seemed unable to help.

Dave had been using alcohol for many years and had asked for support on several occasions – only to be passed from service to service:

I was made redundant and, at 50, was finding it hard to get another job. I wasn’t drinking all of the time then. But as I started to get into more debt and the bailiffs were knocking on the door, I needed a drink to get me through it. It was not until I was charged with drunk driving that I knew I had a problem.

Dave said he wasn’t shy about asking for help – at least, for a while. But he found himself caught in a downward spiral that led to more drinking, more suffering, and less support:

So many times I’d stop drinking, but I couldn’t deal with the voices in my head. I’d ask for support, but the waiting lists were so long. The medication the doctor gave me did nothing, so I’d start drinking again, and because I’d start to drink again, mental health services wouldn’t touch me. All they kept saying was: ‘You should stop drinking first.’

Graffiti reading 'SAD & HIGH' next to a teary eye.

The biggest barrier to getting support

To expand my understanding, I also sought the perspectives of a dozen people working on the frontline of mental healthcare – from professionals in NHS mental health and substance use teams, to people working for charitable support groups. Their insights revealed a frayed and fragmented network of services , with the holes and inefficiencies obvious and crying out for attention and repair. As one nurse explained:

The stress of trying to get services to help is unbelievable. You’ve got pressure from the person’s family because they are afraid they’ll end up dead. You’ve got pressure from managers to discharge the person. All I’d get is criticism which far outweighed encouragement or support. The stress made me so anxious that I almost gave it all up – and even considered suicide myself.

Over 80% of the professionals I spoke to called for an integration of mental health and substance use teams, in part because of the huge cuts nationwide in funding to substance use services. One social worker in a substance use service explained the current situation:

If you get someone with an alcohol addiction, it becomes quite apparent that they use drink as a way of coping with their mental health. But, because of massive waiting lists within mental health services or because they are told they need to stop drinking before [they can be treated], mental health support can’t be offered. So, the person just keeps drinking and eventually disengages from our services as there is no hope for them. We shouldn’t expect someone to stop using a substance that they perceive is helping without offering an alternative treatment.

For all the professionals I interviewed, the most significant barrier to getting support for someone’s mental health issues was that they used substances and would not receive any treatment until they addressed this. As one mental health nurse told me:

I had one chap who was using cocaine, mainly due to social anxiety. Initially, he’d use it when socialising with friends. But because it gave him confidence and he could talk to people, he started to use it all the time and got himself in debt. I wanted to address the root cause, the social anxiety, so I referred him to our Improving Access to Psychological Therapy service. But I was told he needed to be abstinent from cocaine for three months before they’d accept him. He eventually disengaged, and I haven’t seen him since.

The word HELP spelled out in white powder

A seismic shift is needed

In the shadows of our society, hidden behind the walls of our prisons and in the dark corners of our streets, the experiences of Jenny and countless others bear witness to the profound failings of our healthcare system to address co-existing mental health and substance use issues. For those caught in the merciless cycle of addiction and illness, these systemic inefficiencies and administrative blockades do much to intensify their torment.

Their often brutally honest accounts (and the insights of those who try to support them) draw a portrait of a split and underfunded service, collapsing under the weight of its contradictions. The loud calls for integrated mental health and substance addiction treatment become muffled amid the bureaucratic din of funding cuts, lengthy waiting lists and policy neglect.

The evidence overwhelmingly confirms the need for a model of care that is holistic and integrated – one that shifts the narrative from stigma and isolation to awareness and support.

The economic case for reshaping investment in our mental health and substance misuse services is powerful. The annual cost of mental health problems to the UK economy is a staggering £117.9 billion – equivalent to 5% of its annual GDP – with substance misuse adding a further £20 billion .

However, these figures tell only part of the tale. While we know that 70% of people in treatment for drug misuse and 86% of people in treatment for alcohol misuse have a mental health diagnosis, the full financial impact of people with these co-occurring disorders is probably far greater.

This also includes people who often plough through a punitive and bewildering series of services as they navigate their intersecting problems, encountering barriers at every turn that fail to address their acute health and social care needs. As their distress is amplified, the costs to wider society escalate too – as one social worker explained to me:

I am currently supporting a woman who is struggling with alcohol dependency, a condition that began after she endured significant domestic abuse. The cycle is devastating: her trauma cannot be effectively addressed because of her dependency on alcohol, and she cannot abandon alcohol because it’s the only solace she finds from her emotional torment. Despite several attempts at rehabilitation, none of the programmes have sufficiently tackled the mental health aspects of her trauma. Now, with cirrhosis of the liver, her health is in critical decline. It’s a heart-wrenching situation – a stark reminder of the desperate need for integrated treatment approaches that address both substance dependency and the underlying psychological trauma.

Out-of-focus woman with a glass of alcohol on the table in front of her

‘I might as well be dead’

In the quiet confines of a West Midlands mental health crisis centre, I’m preparing to meet someone whose story I know only from the clinical notes on my screen. The phrase “is alcohol dependent” is highlighted in bold. Behind those words is another person whose life is unravelling in the silence of a battle fought alone.

John walks into the room, a man living in the grip of two relentless forces – addiction and mental illness. “It was just to stop the noises,” he says of the whisky he uses as medication for his inner turmoil. His hands are trembling. This is the moment of truth – his story is no longer trapped within the clinical pages of a case file.

“I’ve lost everything,” he tells me. “I might as well be dead.”

Then John explains why he’s given up hope:

I’ve asked for help so many times, but all I get told is that I need to stop drinking before my mental health can be treated. However, alcohol is the only thing that works for me. I’ve gone through detox, but then I had to wait months for counselling. I just can’t cope that long without any support – antidepressants don’t do anything for me. What’s the point?

Over the past 15 years, I have met countless “Johns”, both during my day job as a mental health social worker and, latterly, in my academic research. This has led me to conclude that the health and social care system in which I work falls catastrophically short.

This is no mere professional critique. It is an impassioned plea for society to rediscover its collective heart; to explore the human stories that lie hidden in statistics such as that, between 2009 and 2019, 53% of UK suicides were among people with comorbid diagnoses of mental health and substance use.

Instead of viewing people through the limiting lens of labels, we should endeavour to see their humanity. Engaging in conversation, extending empathy and showing compassion are powerful actions. A kind word, an understanding nod or a gesture of support can affirm their dignity and spark a connection that resonates with their innate human spirit. Or as John, whose journey I’ve had the privilege to witness, puts it:

It’s not about the help offered but the meaning behind it. Knowing you’re seen as a person, not just a problem to be solved – that’s what sticks with you.

*All names in this article have been changed to protect the anonymity of the interviewees.

If you or anyone you know require expert advice about the issues raised in this article, the NHS provides this list of local helplines and support organisations .

For you: more from our Insights series :

Insomnia: how chronic sleep problems can lead to a spiralling decline in mental health

Existential crisis: how long COVID patients helped us understand what it’s like to lose your sense of identity and purpose in life

OCD is so much more than handwashing or tidying. As a historian with the disorder, here’s what I’ve learned

How music heals us, even when it’s sad – by a neuroscientist leading a new study of musical therapy

To hear about new Insights articles, join the hundreds of thousands of people who value The Conversation’s evidence-based news. Subscribe to our newsletter .

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Drugs and Alcohol 101: The Facts You Need to Know

Two hands clink glasses of whiskey at home,on the couch, cozy

Through the years, Americans’ view of alcohol and drugs has changed. While alcohol was once prohibited, it’s now an accepted part of culture. Marijuana is making a similar transition. Regardless of how you feel about each, alcohol and drug use pose a substantial problem.

“Most people don’t read the fine print,” says Mashal Khan, M.D., psychiatrist, associate professor of Clinical Psychiatry and associate program director of Addiction Psychology Fellowship at Weill Cornell Medicine. “I wish everyone was informed, but few fully understand the substances they put into their bodies.”

Before you use alcohol or drugs, here’s what you should know about each.

Drugs Evolve Over Time

Though the name of drugs stay the same, their potency changes. Marijuana is a clear example.

THC is the substance in marijuana that gives you a high. In recent decades, the amount of THC in marijuana has increased exponentially. According to an article published in Missouri Medicine , marijuana had less than 2% THC before 1990. Some strains in California are now as high as 45%. As a result, Dr. Khan says today’s marijuana, “...tends to knock the socks off most people trying it for the first time.”

Modern drugs aren’t just more potent. They’re also more addictive. If laced with other substances, they can be dangerous and even deadly. The Centers for Disease Control and Prevention states that 150 deaths occur every day due to fentanyl and other opioids .

How Much Alcohol Should You Drink?

Dr. Khan says the big problem with alcohol is knowing when to stop. If you choose to drink, adhere to the following recommendations :

Men should drink no more than two drinks per day
Women should drink no more than one drink per day

Drink more, and you may damage your liver or other organs. You also increase your risk of developing a use disorder. Start drinking alcohol at an early age, and your risk level rises .

“The earlier people drink,” Dr. Khan says, “the more likely they are to develop an unhealthy relationship or alcohol use disorder .”

Identifying and Acting on Addiction

Whether you use alcohol or drugs, early signs that you’re heading toward or experiencing addiction include:

Difficulty functioning socially or professionally
Having loved ones tell you your habit has ha d negative impacts on your own or their lives
Inability to stop using substance when intended
Needing alcohol or drugs to socialize, unwind or cope with stress

Fortunately, the stigma of addiction has lessened , to an extent, in recent decades as more people learn about them. Use disorders are now considered diseases and treated as such. Counseling and other services help you overcome addiction, both in-person and online.

“If you’re struggling to cut back on your use of alcohol or drugs and it’s affecting you in any way, please seek help,” Dr. Khan says. “Talk to your primary care provider and loved ones. There are countless resources that can help you move toward better health.”

Are you living with alcohol or drug use disorder? Don’t face it on your own. Find a doctor at Weill Cornell Medicine to discuss your concerns with.

Inaugural ‘Empowered Life Summit’ emphasizing risks of drug, alcohol abuse

H ATTIESBURG, Miss. (WDAM) - Local organizations and local law enforcement agencies gathered in the University of Southern Mississippi’s Thad Cochran Center on USM’s campus to create a physical space for safe discussions about drugs, alcohol and the policing of substances.

The University of Southern Mississippi’s Prevention Committee, comprised of DREAM of Hattiesburg, Moffit Health and Southern Miss Sports Properties, started educating USM’s campus through a social media campaign about the dangers of drugs and alcohol.

Those media messages were brought to life Wednesday through the inaugural “Empowered Life Summit.”

“We want individuals to be knowledgeable about what you’re consuming in your body,” said Dr. Lisa Vasquez, DREAM of Hattiesburg executive director.

Steven Maxwell, Mississippi Department of Public Safety administrative officer, said drug use was a losing fight.

“When you make the decision to misuse pharmaceutical drugs or use illicit drugs, you are essentially signing up to fight an octopus,” Maxwell said. “The octopus has a knife on each appendage and you only have one in each hand.”

Organizers said although drug use can start as something small and fun, like vaping, it can quickly grow into a dangerous addiction.

“One of the drugs we’re concerned about is kratom,” Maxwell said. “It seeks out the same receptor in the body as synthetic and prescription opioids.”

Students on campus said they were worried about their classmates and hope Empowered Life makes a difference.

“Being a student here on campus, I see these people every day,” said Brayleigh Johnson, DREAM media coordinator and student at USM. “We all walk the same halls, so just drawing people in and saying, ‘Hey I’m a student. You’re a student. Let’s focus on what really matters.’”

In response to the rise of substance abuse, the state of Mississippi has made strides in legislation.

“Our legislature fully understands what is going on,” Maxwell said. “This is a priority for them and they are working on it.”

So far, the state has passed Parker’s Law, The Good Samaritan Law and the Victoria Huggins Pill Press Act.

Each piece of legislation is designed to protect vulnerable people involved in drug-related incidents and prosecute those responsible for drug-related deaths.

For those struggling with drug or alcohol abuse or simply would like to learn more about the dangers of these substances, visit DREAM of Hattiesburg website, here .

Want more WDAM 7 news in your inbox? Click here to subscribe to our newsletter.

More From Forbes

Adhd medications might help prevent drug & alcohol overdose.

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Concerta pills ADHD medication are seen in this illustration photo in Warsaw, Poland on 13 February, ... [+] 2024. (Photo by Jaap Arriens/NurPhoto via Getty Images)

A recent study that included 148,000 people diagnosed with attention deficit hyperactivity disorder (ADHD) found that taking prescribed ADHD medications was linked to lower rates of premature deaths from unnatural causes like accidental drug and/or alcohol overdoses and unintentional injuries.

Researchers based in Europe and the U.S. followed close to 150,000 Swedish people with ADHD between 2007 and 2018. Their ages ranged from 6 to 64 years. The team observed the risk of premature death from natural and unnatural causes among those who started taking prescribed ADHD medications within three months of a diagnosis compared to those who remained unmedicated.

Around 56.7% of the participants were on either one of the six medications licensed for ADHD treatment in Sweden: methylphenidate, amphetamine, dexamphetamine, lisdexamfetamine, atomoxetine, and guanfacine. Whereas the other 43.3% of total participants did not opt for ADHD medication treatment.

Lead author of the study, Lin Li, a researcher at the Karolinska Institutet in Stockholm, Sweden, and colleagues noted that among medicated participants, the risk of dying from drug and alcohol overdose decreased the most. Among the male participants, they did not find any association between ADHD medication and reduced risks of dying from natural causes like a physical health condition. Interestingly, among the women who participated in the study, ADHD medication initiation was associated with a lower rate of natural-cause mortality.

“Although most ADHD medication initiators (91.9%) started with stimulants, initiation of stimulants vs non-stimulants showed no significant difference in terms of the all-cause mortality rate,” the researchers noted in the study, which was published in JAMA Network on March 12, 2024.

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“ADHD medication may reduce the risk of unnatural-cause mortality by alleviating the core symptoms of ADHD and its psychiatric comorbidities, leading to improved impulse control and decision-making, ultimately reducing the occurrence of fatal events, in particular among those due to accidental poisoning,” the researchers wrote.

“Previous studies have reported improvements in comorbid psychiatric symptoms when ADHD is effectively treated. For instance, early and optimal treatment of ADHD may alter the trajectory of psychiatric morbidity by preventing the onset of comorbidities such as mood, anxiety, or substance use disorders,” they added. “There is also evidence showing that ADHD medications were associated with lower risk of accidents, substance use, and criminality, which in turn could lead to lower rates of unnatural deaths.”

Prior studies have concluded that stimulant medication like methylphenidate is linked to lower rates of smoking in adults, which results in better health outcomes. Other than that, multiple studies have found that methylphenidate is associated with improvements in emotional self-regulation, enhanced executive functioning, and decreased impulsivity which could further lower natural mortality risks linked to ADHD.

Despite these benefits, long-term usage of stimulant ADHD medication could impact people’s cardiovascular health irrespective of their age. A 2023 JAMA Psychiatry study found that using ADHD medications was linked to an increased risk of developing arterial disease and high blood pressure. Sweden-based researchers highlighted that more than one year of use heightened the relative risk of these cardiovascular diseases by 9% and two or more years had a 15% elevated risk. The percentage could increase to a 27% higher risk of cardiovascular disease after three or more years of taking an ADHD medication.

“The results of the current study were reassuring because ADHD medication was not associated with an increased risk of natural-cause mortality and, if anything, was associated with a reduced risk of natural-cause mortality in females. Nevertheless, future studies with larger sample sizes are warranted to confirm the relationship between ADHD medication use and natural-cause morbidity and mortality,” Li and team concluded in the study.

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Angela Chao's blood-alcohol level was nearly 3 times the legal limit when she drowned in her Tesla, police report shows

The police concluded Angela Chao's death was an accident; her blood-alcohol concentration was 0.233.
The shipping magnate Chao drove her Tesla into a pond in February while on a ranch with friends.
The police had initiated a criminal investigation, and questions were raised about Tesla controls.

Angela Chao , the shipping magnate who drowned after backing her Tesla into a pond on her Texas ranch, had a blood-alcohol level nearly three times the legal limit when she died, newly released police records show.

Chao was the CEO of Foremost Group, the wife of the venture capitalist Jim Breyer, and the sister of the former Cabinet secretary Elaine Chao, who is the wife of Senate Minority Leader Mitch McConnell.

Chao's sudden death occurred in Blanco County, outside Austin, in the early-morning hours of February 11. The local authorities initially declined to share many details, saying they were still investigating.

On Wednesday, the Blanco County sheriff released 62 pages of records. The documents said Chao's death was an "unfortunate accident." It also said her blood-alcohol concentration was 0.233 grams per 100 milliliters, which is about three times the legal limit of 0.08 grams per 100 milliliters.

The police report said Chao was hosting a group of women at her ranch when she died. The group had dinner at the guest lodge on the property on Saturday, February 10. Afterward, at about 11:30 p.m., Chao planned to drive from one building on the ranch to another because it was cold outside. But the police said that after getting into her car, she accidentally reversed into a pond.

The report describes attempts by Chao's friends, an employee, and first responders to save her from the pond, which was situated between the main house and the guest house on the remote ranch. Even though one of the back doors of the car was open, officers could not pull her out of it, and it took them several minutes to break the driver's-side window and extract her body.

Watch: VIDEO: Matthew McConaughey makes an emotional plea for more gun control

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Drug and alcohol treatment for victims and suspects of homicide

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Drug and alcohol treatment for victims and suspects of homicide: pre-release access list

Published 28 March 2024

Applies to England

This publication is licensed under the terms of the Open Government Licence v3.0 except where otherwise stated. To view this licence, visit nationalarchives.gov.uk/doc/open-government-licence/version/3 or write to the Information Policy Team, The National Archives, Kew, London TW9 4DU, or email: [email protected] .

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This publication is available at https://www.gov.uk/government/statistics/drug-and-alcohol-treatment-for-victims-and-suspects-of-homicide/drug-and-alcohol-treatment-for-victims-and-suspects-of-homicide-pre-release-access-list

The following post holders are given pre-release access 24 hours before the release of this report. Statistical staff and other staff involved in the production and quality assurance of the report are not on this list.

Department of Health and Social Care

Department of Health and Social Care staff with pre-release access to the statistics are:

Director General, Global Health
Director of Health Improvement
Special Adviser
Addictions Adviser
Secretary of State’s Portfolio Secretary
Media Relations Officer
Director of Analysis
Chief Medical Officer ( CMO )
Private Secretary to CMO
Deputy Chief Medical Officer

Home Office staff with pre-release access to the statistics are:

Home Secretary’s Special Adviser
Programme Director, Crime Statistics Production and Analysis
Head of Office for Minister Chris Philp
Drugs, Exploitation and Abuse Analysis
Head of Serious Violence Reduction Unit
Head of Homicide Policy
Senior Press Officer
Communications Officer

Ministry of Justice

Ministry of Justice staff with pre-release access to the statistics are:

Deputy Private Secretary to Minister Edward Argar
Ministerial Engagement Lead and Adviser
Policy Adviser, Community Substance Misuse Policy
Head of Substance Misuse Policy
Community Substance Misuse Policy

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